| Doctor Name: | NEIL R KELLEY |
| NPI Number: | 1437184025 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 000E23210 |
| Business Practice Address: | 1730 Main St Fortuna, CA - 955402451 |
| Business Phone Number: | 7077255223 |
| Business Fax Number: | 7077252756 |
| Mailing Address: | 1730 Main St, FORTUNA |
| State: | CA |
| Postal Code: | 955402451 |
| Phone Number: | 7077255223 |
| Fax Number: | 7077252756 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 03/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ER0200X |
| License Number: | 000E23210 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Radiology |
| Taxonomy Definition: | |