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Contact Information

NEIL R KELLEY, DPM
1730 MAIN ST
FORTUNA, CA95540-2451
 Phone: 707-725-5223
 Fax: 707-725-2756
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
 

Radiology

213ER0200X 48 Podiatry
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for NEIL R KELLEY · (Male)

NPI Number 1437184025
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/11/2006
Last updated 03/27/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • CA License # 000E23210
  • CA Medicaid GRE001770
  • CA Other 201857499 BLUE CROSS
  • CA Other ZZZ64278Z BLUE SHIELD
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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