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Organization
JEFFERY S KELLEY MD
Active
Organization
JEFFERY S KELLEY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFERY SCOTT KELLEY MD (OWNER/PRESIDENT)
(850) 675-4546
Entity
Organization
Contact information
Practice address
14088 ALABAMA ST, JAY, FL 32565-1036
(850) 675-4546
(850) 675-4548
Mailing address
PO BOX 10, JAY, FL 32565-0010
(850) 675-4546
(850) 675-4548
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME81689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009952450
ALACAID
AL
01
—
05101
BLUE CROSS AND BLUE SHIELD OF FLORIDA
—
01
—
1203400
COVENTRY
—
01
—
2239990
UNITED HEALTHCARE
—
05
—
261059100
—
FL
01
—
4071564
CIGNA
—
01
—
59037346
BLUE CROSS AND BLUE SHIELD OF ALABAMA
—
01
—
591032244
CHAMPVA
—
01
—
7032394
AETNA
—
01
—
A611
WELLCARE
—
01
—
P00017883
RAILROAD MEDICARE
—
Enumeration date
05/14/2012
Last updated
05/14/2012
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