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NPI Code Detail

MEDICARE: DR. SCOTT DAVID KELLEY PHARMD

MEDICARE: DR. SCOTT DAVID KELLEY PHARMD
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
1183500000XPharmacist34500TN

General Provider Information

NPI Number : 1447689070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT DAVID KELLEY PHARMD
Provider Business Mailing Address
First Line : 3051 KINZEL WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37924-2190
Country : US
Telephone Number : 865-544-0120
Fax Number : 865-544-0026
Provider Business Practice Location Address
First Line : 3051 KINZEL WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37924-2190
Country : US
Telephone Number : 865-544-0120
Fax Number : 865-544-0026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2013
Last Update Date : 11/04/2013

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