MEDICARE: JOSEPH ANTHONY KELLING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	U2531	TX

General Provider Information

NPI Number	:	1285161794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH ANTHONY KELLING MD

Provider Business Mailing Address
First Line	:	3600 GASTON AVE BARNETT TOWER STE 410
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-7521
Country	:	US
Telephone Number	:	214-827-2531
Fax Number	:	214-826-6754

Provider Business Practice Location Address
First Line	:	3600 GASTON AVE BARNETT TOWER STE 410
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75246-7521
Country	:	US
Telephone Number	:	214-827-2531
Fax Number	:	214-826-6754

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2017
Last Update Date	:	08/01/2023

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