| Organization Name: | KEITH S KELLY MD PC |
| NPI Number: | 1912183781 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEITH S KELLY (PRESIDENT) |
| Mailing Address: | 7627 Leonardtown Rd Suite 103a Hughesville |
| State: | MD US |
| Postal Code: | 206373005 |
| Phone Number: | 3016326900 |
| Fax Number: | 3016326901 |
| NPI Enumeration Date: | 01/11/2008 |
| NPI Last Update Date: | 03/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | D0054969 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |