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General NPI Number Information
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NPI Number | 1902902182
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Entity Type | Individual
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Provider Name | THOMAS ANDREW KELLY M.D. FACC
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 3200 NORTHLINE AVE STE 250
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City | GREENSBORO
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State | NC
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Zip | 27408-7619
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Country | US
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Telephone | 336-273-7900
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Fax | 336-275-0433
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Provider Business Mailing Address
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Address Line | PO BOX 745040
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City | ATLANTA
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State | GA
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Zip | 30374-5040
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Country | US
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Telephone |
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Fax |
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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 | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 27216
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 27216
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 27216
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License Number State | NC
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