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NPI Code Detail

MEDICARE: DR. ROBERT T KELLEY D.O.

MEDICARE: DR. ROBERT T KELLEY D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianTL0005132CO
2207Q00000XFamily Medicine PhysicianDR.0055887CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093126427
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT T KELLEY D.O.
Provider Business Mailing Address
First Line : 4650 SIGNAL TREE DR STE 1200
Second Line :
City : TIMNATH
State : CO
Zip : 80547-4908
Country : US
Telephone Number : 970-237-7415
Fax Number : 970-237-7420
Provider Business Practice Location Address
First Line : 4650 SIGNAL TREE DR STE 1200
Second Line :
City : TIMNATH
State : CO
Zip : 80547-4908
Country : US
Telephone Number : 970-237-7415
Fax Number : 970-237-7420
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2014
Last Update Date : 05/29/2020

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Directions to “ DR. ROBERT T KELLEY D.O.” Practice Location

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