Individual
DR. LESTER KELTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036056379
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036056379
BCILLINIOS
—
01
—
143400
IHS
—
05
—
1927525
—
IA
05
—
2927525
—
IA
01
—
91481
BCWELLMARK 7TH
—
01
—
93361
BCWELLMARK WEST
—
01
—
IL0181
JOHN DEERE
—
Enumeration date
03/24/2006
Last updated
12/08/2011
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