Healthcare Provider Details

I. General information

NPI: 1679563282
Provider Name (Legal Business Name): KELLY F ENGLAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 S DOBSON RD SUITE B220
MESA AZ
85202-4712
US

IV. Provider business mailing address

1450 S DOBSON RD STE B220
MESA AZ
85202-4745
US

V. Phone/Fax

Practice location:
  • Phone: 480-615-2010
  • Fax: 480-899-4550
Mailing address:
  • Phone: 480-827-5044
  • Fax: 480-827-5125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25334
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: