Individual
DR. JOHN HANSFORD KELLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3903 WISEMAN BLVD, SUITE 215, SAN ANTONIO, TX 78251-4401
(210) 675-6724
(210) 675-1759
Mailing address
8920 US HIGHWAY 87 E, STE.# 3, SAN ANTONIO, TX 78263-2238
(210) 648-0152
(210) 649-4170
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
J0844
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115386801
—
TX
Enumeration date
09/19/2005
Last updated
11/21/2016
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