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General NPI Number Information
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NPI Number | 1679572515
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Entity Type | Individual
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Provider Name | STEPHEN POWELL KELLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 100 S PARK DR
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City | BROWNWOOD
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State | TX
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Zip | 76801-5918
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Country | US
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Telephone | 325-643-3561
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Fax | 325-646-0670
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Provider Business Mailing Address
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Address Line | 100 S PARK DR
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City | BROWNWOOD
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State | TX
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Zip | 76801-5918
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Country | US
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Telephone | 325-643-3561
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Fax | 325-646-0670
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | E6451
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License Number State | TX
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