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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. KELLY L. MCDONALD, PA

Active

MR. KELLY L. MCDONALD, PA is a Physician Assistant healthcare provider located in ESTANCIA, New Mexico. NPI 1972516359 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · ESTANCIA, NM

Registration Details

NPI Number
1972516359
Provider Type
Individual
Gender
Male
NPI Issued
Aug 15, 2006 (19.816681867877 yrs)
Last Updated
Sep 8, 2023
Licenses
237 (NM)
PA2013-0057 (NM)

Practice Information

Address
903 5TH ST # C
ESTANCIA, NM, 870161155
Browse NM providers · Browse ZIP 87016
Phone
5053842777
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in ESTANCIA, NM

Name Credential NPI
ANDREW THOMAS THEUS PA-C 1568029239
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.