Charles Kelly, D.O.

NPI #1104895267 in Fulton, Mississippi

Provider Information

NPI Number: 1104895267
Entity Type: Individual
Name: Charles Kelly, D.O.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: D.O.
Enumeration Date: Mar 14, 2006
Last Updated: Mar 8, 2011

Practice Location

Address: 1 MEDICAL PARK DR
City: Fulton
State: Mississippi
ZIP Code: 38843-9001
Phone: (662) 862-5200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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