Basic Information
Provider Information
NPI: 1851634398
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAGY
FirstName: KELLY
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 88 MDG
Address2: 4881 SUGAR MAPLE DR
City: WRIGHT PATTERSON AFB
State: OH
PostalCode: 454335529
CountryCode: US
TelephoneNumber: 9372571160
FaxNumber: 9372573012
Practice Location
Address1: 7700 UNIVERSITY DR
Address2:  
City: WEST CHESTER
State: OH
PostalCode: 450692505
CountryCode: US
TelephoneNumber: 5134758248
FaxNumber: 5134758468
Other Information
ProviderEnumerationDate: 04/03/2013
LastUpdateDate: 10/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X35.135157OHY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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