Individual
JACK E KEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
400 MEDICAL PARK DR, STE 203, DOVER, OH 44622-3207
(330) 343-3433
(330) 343-3449
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35128964
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
06/06/2011
Last updated
12/23/2016
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