Kelly Family Medical Center P.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

4301080987 Issued in MI

Legal business name

KELLY FAMILY MEDICAL CENTER P.C.

Practice address

21331 Kelly Rd Ste 120
Eastpointe, MI 48021-3265

Phone

(586) 585-9119

Fax

(586) 585-9947

NPI assigned

Apr 20, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alphonse A Ekole, M.D.

Title

President

Phone

(586) 585-9119

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1669799318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21331 KELLY RD STE 120",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213265",
            "telephone_number": "586-585-9119",
            "fax_number": "586-585-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21331 KELLY RD STE 120",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213265",
            "telephone_number": "586-585-9119",
            "fax_number": "586-585-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY FAMILY MEDICAL CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "EKOLE",
        "authorized_official_first_name": "ALPHONSE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-585-9119",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MI",
            "license": "4301080987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dina Katchi
• Kateland Home Service Inc
• Raminder Kaur
• Leslie Keaton
• Virginia Keena, MA, LLP
• Kelly Pharmacy LLC
• Jeneca Kennedy
• Kenneth Dziuba MD PC
• Kevin T. Kensora, D.D.S.
• Marya Khairullah, MA, LLP

• Primary Care Clinic/Center in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Primary Care Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.