Kelly, Douglas A

Kelly, Douglas A is an individual health care provider with primary practice located at 1 Mercado St Ste 100 , Durango CO 81301-7306. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Kelly, Douglas A can be contacted via phone (970) 385-4746.

Contact Information

Primary practice address
1 Mercado St Ste 100 Durango CO 81301-7306
Phone: (970) 385-4746
Fax: (970) 259-5787
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X 19729 Oklahoma
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X DR0062949 Colorado

Profile Details

NPI number 1497716781
LBN Legal business name Kelly, Douglas A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Jan 22nd, 2020 - about 6 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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Identifiers

StateTypeNumberIssuer
All States NPI 1497716781 NPPES
Colorado MEDICAID 9000175543

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