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NPI Code Detail

MEDICARE: DR. RALPH WHITLEY KELLY DO

MEDICARE:  DR. RALPH WHITLEY KELLY  DO
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
1207P00000XEmergency Medicine PhysicianE6114TX

General Provider Information

NPI Number : 1336253707
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RALPH WHITLEY KELLY DO
Provider Business Mailing Address
First Line : 2405 WINDING HOLLOW LN
Second Line :
City : PLANO
State : TX
Zip : 75093-4108
Country : US
Telephone Number : 972-612-1005
Fax Number :
Provider Business Practice Location Address
First Line : 7 MEDICAL PKWY
Second Line :
City : DALLAS
State : TX
Zip : 75234-7823
Country : US
Telephone Number : 972-888-7264
Fax Number : 214-712-2487
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/08/2007

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Directions to “ DR. RALPH WHITLEY KELLY DO” Practice Location

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