Organization
JON A KELLY DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON A. KELLY D.P.M. (OWNER AND OPERATOR)
(412) 673-9222
Entity
Organization
Contact information
Practice address
1601 LINCOLN WAY, WHITE OAK, PA 15131-1720
(412) 673-9222
(412) 673-0022
Mailing address
1601 LINCOLN WAY, WHITE OAK, PA 15131-1720
(412) 673-9222
(412) 673-0022
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC003063L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010971010011
—
PA
01
—
1396761268
INDIVIDUAL NPI
PA
01
—
602340
HIGHMARK GROUP NUMBER
PA
Enumeration date
05/16/2007
Last updated
11/01/2010
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