MEDICARE: DOUGLAS WAYNE KELLY M.D.

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
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	12896	AZ

General Provider Information

NPI Number	:	1104924158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS WAYNE KELLY M.D.

Provider Business Mailing Address
First Line	:	5501 N 19TH AVE
Second Line	:	432
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2450
Country	:	US
Telephone Number	:	602-242-7691
Fax Number	:	602-242-7265

Provider Business Practice Location Address
First Line	:	5501 N 19TH AVE
Second Line	:	432
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2450
Country	:	US
Telephone Number	:	602-242-7691
Fax Number	:	602-242-7265

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1336916105 — KINGSLEY EBORU
Practice Location Address:

5501 N 19TH AVE
PHOENIX, AZ
85015-2450

Practice Phone: 602-755-8343
Practice Fax: 602-755-8362

1972562965 — CONTINENTAL DENTAL CARE LLC
Practice Location Address:

5501 N 19TH AVE , SUITE 103
PHOENIX, AZ
85015-2450

Practice Phone: 602-864-1119
Practice Fax: 602-249-5080

1154429694 — SALUBRIOUS HEALTH CARE PC
Practice Location Address:

5501 N 19TH AVE , 218
PHOENIX, AZ
85015-2450

Practice Phone: 602-242-1221
Practice Fax: 623-915-0280

1255432597 — VICTOR TSENG, MD, PC
Practice Location Address:

5501 N 19TH AVE , STE 331
PHOENIX, AZ
85015-2450

Practice Phone: 602-242-7796
Practice Fax: 602-249-2353

1649371881 — DR. SAUL N SCHREIBER M.D.
Practice Location Address:

5501 N 19TH AVE , STE 331
PHOENIX, AZ
85015-2450

Practice Phone: 602-242-7796
Practice Fax: 602-249-2353

1306947551 — DESERT ORTHOPAEDICS & REHABILITATION, PC
Practice Location Address:

5501 N 19TH AVE , STE 331
PHOENIX, AZ
85015-2450

Practice Phone: 602-242-7796
Practice Fax: 602-249-2353

Directions to “ DOUGLAS WAYNE KELLY M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.