Individual
SCOTT KLEMENT KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 MEDICAL CENTER DR, SPRINGFIELD, OH 45504-2687
(937) 390-9665
(937) 390-2363
Mailing address
100 MEDICAL CENTER DR, SPRINGFIELD, OH 45504-2687
(937) 390-9665
(937) 390-2363
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
34.005285
OH
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
34 005285
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000017758
ANTHEM
OH
05
—
0847169
—
OH
Enumeration date
04/12/2006
Last updated
08/13/2012
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