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Individual

JON GREGORY MCKELLAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2218 SHALLOCK AVE, KLAMATH FALLS, OR 97601-4290
(541) 883-8134
(541) 883-1510
Mailing address
2218 SHALLOCK AVE, KLAMATH FALLS, OR 97601-4290
(541) 882-3818
(541) 882-9800

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD11585
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245228980
NPI
OR
Enumeration date
10/06/2005
Last updated
05/16/2019
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