Lawrence J Kelly in Surprise - Sports Medicine
Lawrence J Kelly - NPI 1124014758
Lawrence J Kelly is a Sports Medicine in Surprise, Arizona. Lawrence J Kelly practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Lawrence J Kelly is 1124014758. The last update date is 2016-06-06.
Lawrence J Kelly's current location address is 12361 W Bola Dr, Surprise, Arizona. You can contact this provider via phone number 6235845626 and fax number 6235848998. The mailing address for Lawrence J Kelly is 12361 W Bola Dr, Surprise, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Lawrence J Kelly |
|---|---|
| Address | 12361 W Bola Dr, Surprise, Arizona |
| Phone Number | 6235845626 |
| Fax Number | 6235848998 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1124014758 |
|---|---|
| Provider Enumeration Date | 2005-09-20 |
| Last Updated Date | 2016-06-06 |
Provider Mailing Address Detail
| Address | 12361 W Bola Dr |
|---|---|
| City | Surprise |
| State | Arizona (AZ) |
| Post Code | 853789021 |
| Phone Number | 6235845626 |
| Fax Number | 6235848998 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | 35083 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5920416 | AZ | AETNA | |
| P00188666 | AZ | RAILROAD MEDICARE | |
| 2036792 | AZ | UNITED HEALTHCARE | |
| 2Z1651 | AZ | HEALTHNET | |
| 1124014758 | AZ | AHCCCS | |
| P0836100 | AZ | BCBS OUT OF AREA | |
| 514829 | AZ | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Lawrence J Kelly by the Centers for Medicare & Medicaid Services?
The Lawrence J Kelly has been issued the NPI (National Provider Identifier) 1124014758. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Lawrence J Kelly is physically located?
The Lawrence J Kelly is physically situated at the following address: 12361 W Bola Dr, Surprise, AZ, 853789021.
What is Lawrence J Kelly's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lawrence J Kelly's specialized field of practice is Sports Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207Xx0005X.
On what date did the Centers for Medicare & Medicaid Services assign the 1124014758 to Lawrence J Kelly?
The Centers for Medicare & Medicaid Services assigned the 1124014758 to Lawrence J Kelly on 2005-09-20.
As of what date were the Lawrence J Kelly's details last updated?
The information pertaining to the Lawrence J Kelly, including its address, specialty, and other details, was most recently updated on 2016-06-06.