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NPI Code Detail

MEDICARE: GEORGE TIMOTHY KELLY MD

MEDICARE:   GEORGE TIMOTHY KELLY  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
1174400000XSpecialistMD5260NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
188-0388402OTHERNVTAX ID #

General Provider Information

NPI Number : 1619944113
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE TIMOTHY KELLY MD
Provider Business Mailing Address
First Line : 7200 CATHEDRAL ROCK DR
Second Line : #110
City : LAS VEGAS
State : NV
Zip : 89128-0438
Country : US
Telephone Number : 702-341-5444
Fax Number : 702-341-5445
Provider Business Practice Location Address
First Line : 7200 CATHEDRAL ROCK DR
Second Line : #110
City : LAS VEGAS
State : NV
Zip : 89128-0438
Country : US
Telephone Number : 702-341-5444
Fax Number : 702-341-5445
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 09/26/2025

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Directions to “ GEORGE TIMOTHY KELLY MD” Practice Location

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