Provider Demographics
NPI:1265624019
Name:THURMON, KELLY GAY (DO)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:GAY
Last Name:THURMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2961 MOSSROCK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5119
Mailing Address - Country:US
Mailing Address - Phone:210-731-4800
Mailing Address - Fax:210-731-4810
Practice Address - Street 1:8542 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1241
Practice Address - Country:US
Practice Address - Phone:210-616-7300
Practice Address - Fax:210-616-7359
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN0508208M00000X, 208M00000X
WAOP60082668208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8881649Medicare PIN