Individual
GEORGE J KELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 7TH AVE STE 200, CHARDON, OH 44024-2909
(440) 285-4999
(440) 285-5870
Mailing address
6480 HARRISON AVE STE 201, CINCINNATI, OH 45247-7961
(440) 285-4999
(440) 285-4996
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35.052298
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610708
—
OH
01
—
139661
ANTHEM
OH
01
—
200022186
MEDICARE RAIL ROAD
OH
01
—
4134463
AETNA
OH
Enumeration date
12/28/2005
Last updated
11/02/2023
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