Kelly, Douglas Wayne
Kelly, Douglas Wayne is an sole proprietor health care provider with primary practice located at 5501 N 19Th Ave 432, Phoenix AZ 85015-2450. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Kelly, Douglas Wayne can be contacted via phone (602) 242-7691.Contact Information
Primary practice address
5501 N 19Th Ave 432
Phoenix AZ 85015-2450
Phone: (602) 242-7691
Fax: (602) 242-7265
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | 12896 | Arizona |
Profile Details
| NPI number | 1104924158 |
|---|---|
| LBN Legal business name | Kelly, Douglas Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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