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Contact Information

MICHAEL J KELLY JR, PA-C
6585 S YALE AVE STE 720
TULSA, OK74136-8320
 Phone: 918-502-5930
 Fax: 918-502-5935
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for MICHAEL J KELLY JR · (Male)

NPI # 1740366111
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 10/28/2006
Last updated 09/22/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • CO License # 2567
  • OK License # 4618
Hospital affiliation(s)
  • MUSKOGEE REGIONAL MEDICAL CENTER - (Acute Care)
    300 ROCKEFELLER DRIVE
    MUSKOGEE, OK 74401
  • SAINT FRANCIS HOSPITAL INC - (Acute Care)
    6161 SOUTH YALE
    TULSA, OK 74136
  • SAINT FRANCIS HOSPITAL SOUTH - (Acute Care)
    10501 EAST 91ST STREET SOUTH
    TULSA, OK 74133
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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