Individual
JASON KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 ABRAHAM FLEXNER WAY, LOUISVILLE, KY 40202-3841
(502) 852-5841
(502) 589-5093
Mailing address
501 E BROADWAY, LOUISVILLE, KY 40202-2043
(502) 589-4856
(502) 589-5093
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
37122
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64044852
—
KY
Enumeration date
11/16/2005
Last updated
07/08/2007
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