IndividualActive
Douglas Kelly, M.D.
NPI 1104924158 · Sports Medicine (Orthopaedic Surgery) Physician · Phoenix, AZ
Provider details
- NPI number
- 1104924158
- Entity type
- Individual
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 12896 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5501 N 19th Ave
432
Phoenix, AZ 85015-2450
Phone: (602) 242-7691
Fax: (602) 242-7265
Approximate (ZIP-level) locationGet directions
Mailing address
5501 N 19th Ave
Phoenix, AZ 85015-2450
Registry dates
- Enumerated
- 2006-09-20
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.