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Individual

DR. GREGORY KELSO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
860 BETHESDA DR, ZANESVILLE, OH 43701-1800
(740) 454-4651
(740) 454-4653
Mailing address
860 BETHESDA DR, ZANESVILLE, OH 43701-1800
(740) 454-4651
(740) 454-4653

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35082836
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000017743
UNISON PIN
OH
01
000000300315
ANTHEM PIN
OH
01
0111122
UHC PIN
OH
01
0949499
GROUP MEDICAID
OH
05
2434600
OH
01
311413469036
CARESOURCE PIN
OH
01
CA1586
GROUP MEDICARE RAILROAD
01
KE4115011
MEDICARE PTAN
01
P00096768
MEDICARE RAILROAD
OH
Enumeration date
12/14/2005
Last updated
08/19/2008
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