Individual
DR. AUGUSTINE J. KELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 7TH AVE, SUITE 100, CHARDON, OH 44024-2908
(440) 285-2020
(440) 285-8448
Mailing address
150 7TH AVE, SUITE 100, CHARDON, OH 44024-2908
(440) 285-2020
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35060480
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0978036
—
OH
01
—
180020602
RAILROAD MEDICARE
OH
Enumeration date
06/15/2006
Last updated
09/09/2022
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