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General NPI Number Information
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NPI Number | 1376561647
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Entity Type | Individual
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Provider Name | WILLIAM H. KELLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 06/15/2015
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Provider Practice Location Address
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Address Line | 7069 US HIGHWAY 67 E
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City | MAUD
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State | TX
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Zip | 75567-4583
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Country | US
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Telephone | 903-244-4850
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Fax | 903-671-7286
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Provider Business Mailing Address
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Address Line | 7069 US HIGHWAY 67 E
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City | MAUD
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State | TX
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Zip | 75567-4583
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Country | US
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Telephone | 903-244-4850
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Fax | 903-671-7286
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | E-7726
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | Q1843
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License Number State | TX
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