person
Dr. Lane Anthony Kelly, MD
General Practice Physician in Eglin Afb, Florida
NPI 1306589700

Lane Anthony Kelly is a General Practice Physician based in Eglin Afb, FL. Lane Anthony Kelly practices in Eglin Afb, FL and has the professional credentials of MD. The NPI Number for Lane Anthony Kelly is 1306589700 and holds a License No. (Florida).

The current practice location address for Lane Anthony Kelly is 307 Boatner Rd Ste 114, Eglin Afb, FL and can be reached out via phone at 850-883-9501.

Location: 307 Boatner Rd Ste 114, Eglin Afb, FL, 32542-1302
person
Provider Profile Details
NPI Number
1306589700
Provider Name
Lane Anthony Kelly
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
307 Boatner Rd Ste 114, Eglin Afb, FL, 32542-1302
Phone Number
850-883-9501
Fax Number
Provider Enumeration Date
04/14/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
307 Boatner Rd Ste 114
City
State
Zip
32542-1302
Phone Number
850-883-9501
Fax Number
person
Provider Business Mailing Address Details
Address
307 Boatner Rd Ste 114
City
State
Zip
32542-1302
Phone Number
850-883-9501
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
License No.
U6993 (Texas)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
()
Definition
Definition to come...
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