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Contact Information

EDWARD L KELLY, MD
1300 E CENTER ST
PROVO, UT84606-3554
 Phone: 801-344-4400
 Fax: 801-344-4225
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Forensic Psychiatry

2084F0202X 86 Physician/Neuropsychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for EDWARD L KELLY · (Male)

NPI Number 1013995471
Status Active
Credentials MD
Entity Individual
Enumeration date 01/05/2006
Last updated 03/24/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MN License # 42929
  • NE License # 26951
  • UT License # 10382404-1205
  • WA License # MD00040860
  • WA Medicaid 1013995471
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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