Individual
JOHN D KELLY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 2 SILVERSTEIN BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-3340
(215) 349-5928
Mailing address
3400 SPRUCE ST, 2 SILVERSTEIN BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-3340
(215) 349-5928
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD034751E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012052630001
—
PA
Enumeration date
10/13/2005
Last updated
08/28/2015
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