Basic Information
| Provider Information | |||||||||
| NPI: | 1851314744 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KELLEY | ||||||||
| FirstName: | WEDDINGTON | ||||||||
| MiddleName: | BISHOP | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 830605 | ||||||||
| Address2: | SUITE 270 | ||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352830605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057155198 | ||||||||
| FaxNumber: | 2057155932 | ||||||||
| Practice Location | |||||||||
| Address1: | 817 PRINCETON AVE SW STE 199 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352111350 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057813752 | ||||||||
| FaxNumber: | 2057887244 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2006 | ||||||||
| LastUpdateDate: | 04/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | 25547 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.