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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 19 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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