Most Relevant Information
Provider Data
| NPI Number: | 1003431164 |
| Provider Name: | JOHN KELLY |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/14/2020 |
| Last Updated: | 06/14/2020 |
Provider Practice Location
118 E CHOCCOLOCCO ST
OXFORD
AL
362031222
Practice Location Phone/Fax
| Phone: | 2568314601 |
| Fax: | 2568353386 |
Provider Mailing Location
118 E CHOCCOLOCCO ST
OXFORD
AL
362031222
Provider Mailing Phone/Fax
| Phone: | 2568314601 |
| Fax: | 2568353386 |