Provider Demographics
NPI:1982626107
Name:KELLS, DOUGLAS U (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:U
Last Name:KELLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2331 FRANKLIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1111
Mailing Address - Country:US
Mailing Address - Phone:540-725-1226
Mailing Address - Fax:540-857-5306
Practice Address - Street 1:2331 FRANKLIN RD SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014-1111
Practice Address - Country:US
Practice Address - Phone:540-725-1226
Practice Address - Fax:540-857-5306
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101018630207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1982626107OtherHEALTHKEEPERS
VA1982626107OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1982626107OtherOPTIMA HEALTH PLAN
VA1982626107OtherGATEWAY
VA1982626107OtherHUMANA MEDICARE
VA1982626107OtherUNITED HEALTHCARE
VA540506332004OtherTRICARE/CHAMPUS
VA1982626107OtherVA PREMIER
VA1982626107OtherANTHEM
VA1982626107OtherHEALTHKEEPERS PLUS
VA1982626107OtherUMWA
VA1982626107OtherINTOTAL
VA1982626107Medicaid
VA1982626107OtherCIGNA
VA1982626107OtherVIRGINIA HEALTH NETWORK
VA371194700OtherBLACK LUNG
VA1982626107OtherAETNA
VAP00628123OtherRAILROAD MEDICARE
VA1982626107OtherSOUTHERN HEALTH/CARENET/CARELINK/COVENTRY
VA1982626107OtherOPTIMA HEALTH PLAN
VA1982626107OtherMAJESTACARE