Individual
DR. JEFFREY JOHN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3643 W FRONT ST, SUITE A, TRAVERSE CITY, MI 49684-7759
(231) 935-0620
(231) 935-0626
Mailing address
3643 W FRONT ST, SUITE A, TRAVERSE CITY, MI 49684-7759
(231) 935-0620
(231) 935-0626
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
055534
GA
207N00000X
Dermatology Physician
Primary
5101020217
MI
Other
Enumeration date
11/18/2005
Last updated
07/24/2013
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