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NPI Profile for RALPH KELLEY in PORTAGEVILLE, MO.
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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Adult Medicine |
207QA0505X | 08 | Physician/Family Practice |
| NPI Number | 1669589677 |
|
| Status | Active | |
| Credentials | DO (Doctor of Osteopathic) | |
| Entity | Individual | |
| Enumeration date | 08/24/2006 | |
| Last updated | 12/20/2016 - About 9 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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RALPH KELLEY
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RALPH KELLEY, DO