Provider Demographics
NPI:1306831243
Name:KELLY, FRANK J II (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:KELLY
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2705
Mailing Address - Street 2:STE 220
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35804-2705
Mailing Address - Country:US
Mailing Address - Phone:256-801-6048
Mailing Address - Fax:256-801-6218
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:SUITE 620
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5134
Practice Address - Country:US
Practice Address - Phone:256-265-4600
Practice Address - Fax:256-265-4651
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2017-01-11
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Provider Licenses
StateLicense IDTaxonomies
AL00019355207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009955755Medicaid
AL2230930OtherFIRST HEALTH PROVIDER #
ALP00603054OtherRR MEDICARE
AL515-35231OtherBCBS OF AL
AL5492768OtherCCN PROVIDER NUMBER
AL510-50070OtherBCBS OF ALABAMA
AL515-19377OtherBCBS OF AL PROVIDER #
AL528701110Medicaid
ALDD6388OtherRAILROAD MCARE PROV. #
ALG38565OtherVIVA HEALTH PROVIDER #
AL009941926Medicaid
ALCA0084OtherRR MEDICARE
AL7008083OtherAETNA PROVIDER NUMBER
ALE359Medicare PIN
ALCA0084OtherRR MEDICARE
AL510-50070OtherBCBS OF ALABAMA
AL009955755Medicaid