Dr Thomas J Kelly, DO | |
1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | |
(850) 863-7607 | |
(205) 437-5998 |
Full Name | Dr Thomas J Kelly |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Experience | 38 Years |
Location | 1000 Mar Walt Dr, Fort Walton Beach, Florida |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629026596 | NPI | - | NPPES |
80923 | Other | FL | BCBS PROVIDER NUMBER |
376379000 | Medicaid | FL | |
059185641 | Other | AL | BCBS PROVIDER NUMBER |
059190499 | Other | AL | BCBS PROVIDER NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | OS6762 (Florida) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Medical Center Enterprise | Enterprise, AL | Hospital |
Tyler Holmes Memorial Hospital Cah | Winona, MS | Hospital |
Washington County Hospital | Chatom, AL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Correct Care, Inc. | 8628980992 | 69 |
Entity Name | Forrest County General Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295837631 PECOS PAC ID: 1052397767 Enrollment ID: O20040624001351 |
Entity Name | Kings Daughters Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043245368 PECOS PAC ID: 3072575539 Enrollment ID: O20041028000174 |
Entity Name | Correct Care, Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215987441 PECOS PAC ID: 8628980992 Enrollment ID: O20131122000662 |
Mailing Address | Practice Location Address |
---|---|
Dr Thomas J Kelly, DO Po Box 88452, Chicago, IL 60680-1452 Ph: (205) 437-6098 | Dr Thomas J Kelly, DO 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 Ph: (850) 863-7607 |
Mrs. Andrea M Person, PA Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-862-1111 | |
Dr. Michael C Williams, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Paula S Wadbrook, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Lon A Boutiette, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. William Mendoza, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Jason H Adams, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 Fax: 205-437-5998 | |
Dr. Grady L Burleson, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Mar Walt Dr, Fort Walton Beach, FL 32547 Phone: 850-863-7607 |