Individual
JOHN JAMES KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104
(215) 662-2022
Mailing address
240 N HIGHLAND AVE NE UNIT 3411, ATLANTA, GA 30307-5617
(774) 278-8184
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MT216144
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2018
Last updated
06/11/2018
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