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General NPI Number Information
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NPI Number | 1972543064
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Entity Type | Individual
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Provider Name | KARL DAVID KELLEY MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 310 N L ROGERS WELLS BLVD
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City | GLASGOW
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State | KY
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Zip | 42141-1300
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Country | US
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Telephone | 270-659-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 4059 KEITH RD
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City | SPRINGFIELD
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State | TN
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Zip | 37172-6971
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Country | US
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Telephone | 615-384-6222
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 38748
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 46833
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License Number State | KY
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