Provider Demographics
NPI:1437492949
Name:KELLY, ANDREW LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:LOUIS
Last Name:KELLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3347
Mailing Address - Country:US
Mailing Address - Phone:918-488-6001
Mailing Address - Fax:
Practice Address - Street 1:7858 S OLYMPIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-1857
Practice Address - Country:US
Practice Address - Phone:918-986-9250
Practice Address - Fax:918-986-9205
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK30014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine