| Doctor Name: | KELLY DAVID GAGE |
| NPI Number: | 1356324370 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 01053434A |
| Business Practice Address: | 301 Fisher St 81 Mdos/sgox Keesler Afb, MS - 395342508 |
| Business Phone Number: | 2283764863 |
| Business Fax Number: | |
| Mailing Address: | 301 Fisher St, 81 Mdos/sgox KEESLER AFB |
| State: | MS |
| Postal Code: | 395342508 |
| Phone Number: | 2283764863 |
| Fax Number: | |
| NPI Enumeration Date: | 11/23/2005 |
| NPI Last Update Date: | 06/02/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 01053434A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |