Provider Demographics
NPI:1851314744
Name:KELLEY, WEDDINGTON BISHOP (MD)
Entity Type:Individual
Prefix:DR
First Name:WEDDINGTON
Middle Name:BISHOP
Last Name:KELLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 830605
Mailing Address - Street 2:SUITE 270
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0605
Mailing Address - Country:US
Mailing Address - Phone:205-715-5198
Mailing Address - Fax:205-715-5932
Practice Address - Street 1:817 PRINCETON AVE SW STE 199
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1350
Practice Address - Country:US
Practice Address - Phone:205-781-3752
Practice Address - Fax:205-788-7244
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25547207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALD67157Medicare UPIN
AL51517862Medicare ID - Type Unspecified