Jack Leslie Kelley, MD | |
1500 Salem St, Lafayette, IN 47904-2164 | |
(765) 448-8000 | |
(765) 448-8337 |
Full Name | Jack Leslie Kelley |
---|---|
Gender | Male |
Speciality | Surgery |
Location | 1500 Salem St, Lafayette, Indiana |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710956065 | NPI | - | NPPES |
000000197818 | Other | IN | ANTHEM PROVIDER NUMBER |
KE80251002 | Medicaid | IN | |
100230510 | Medicaid | IN | |
10825369 | Other | IN | CAQH NUMBER |
9017025 | Other | IN | PHCS PID NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 01022437A (Indiana) | Primary |
Mailing Address | Practice Location Address |
---|---|
Jack Leslie Kelley, MD Po Box 5545, Lafayette, IN 47903-5545 Ph: (765) 448-8000 | Jack Leslie Kelley, MD 1500 Salem St, Lafayette, IN 47904-2164 Ph: (765) 448-8000 |
David Halter, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1345 Unity Pl, Suite 235, Lafayette, IN 47905 Phone: 765-446-5065 Fax: 765-446-5170 | |
Richard C Berg Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-8027 | |
Gerritt F Smith, MD Surgery Medicare: Medicare Enrolled Practice Location: 1701 S Creasy Ln, Lafayette, IN 47905 Phone: 765-423-6690 Fax: 765-423-6691 | |
Dr. Surya Ramachandran Kumar, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 317-923-1787 Fax: 317-962-0853 | |
Dr. Ruban Nirmalan, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-8027 | |
Dr. Lewis Jeremy Johnson, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3920 St Francis Way Ste 105, Lafayette, IN 47905 Phone: 765-428-1660 Fax: 765-428-1627 | |
John E Francis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1345 Unity Pl, Suite 235, Lafayette, IN 47905 Phone: 765-446-5065 Fax: 765-446-5170 |