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Contact Information

KENNETH J KELLY, MD
2000 TRIDENT WAY
SAN DIEGO, CA92155-5599
 Phone: 808-474-9333
 Fax: 619-437-3197
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for KENNETH J KELLY · (Male)

NPI Number 1730224908
Status Active
Credentials MD
Entity Individual
Enumeration date 02/21/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • HI License # MD7948
Hospital affiliation(s)
  • ST FRANCIS MEDICAL CENTER - (Acute Care)
    211 ST FRANCIS DR
    CAPE GIRARDEAU, MO 63703
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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