Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Douglas Wayne Kelly, MD

Individual provider Sports Medicine (Orthopaedic Surgery) Physician · NPI 1104924158

Douglas Wayne Kelly, MD is a Sports Medicine (Orthopaedic Surgery) Physician in Phoenix, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5501 N 19th Ave 432
Phoenix, AZ 85015-2450
Phone: (602) 242-7691
Fax: (602) 242-7265
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence 12896 (AZ)

Record details

NPI number1104924158
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedSeptember 20, 2006
Last updated in NPPESJuly 8, 2007

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