Individual
DR. JUSTIN KELLEY
Active
Individual
DR. JUSTIN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
34.014089
OH
207XX0801X
Orthopaedic Trauma Physician
34.014089
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0381932
—
OH
01
—
34.014089
LICENSE
OH
Enumeration date
04/18/2014
Last updated
08/21/2020
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