MEDICARE: KELLY LYNN VOLLMER 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	207RI0200X	Infectious Disease Physician	200200621	NC
2	207R00000X	Internal Medicine Physician	200200621	NC

General Provider Information

NPI Number	:	1639220841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY LYNN VOLLMER M.D.

Provider Business Mailing Address
First Line	:	839 W CONGRESS ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2819
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-309-2560

Provider Business Practice Location Address
First Line	:	4550 S PALO VERDE RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85714-1943
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-309-2560

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

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	03/25/2025

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