Provider Demographics
NPI:1144408477
Name:BELL, KELLEY AUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:AUSTIN
Last Name:BELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 DUCHESS CT
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-1682
Mailing Address - Country:US
Mailing Address - Phone:859-321-9503
Mailing Address - Fax:502-875-2425
Practice Address - Street 1:103 TWIN OAKS CIR
Practice Address - Street 2:SUITE B
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-8447
Practice Address - Country:US
Practice Address - Phone:502-875-3200
Practice Address - Fax:502-875-2425
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6077203OtherMEDICARE PTAN