| Jeffery S Kelley Md | |
|
14088 Alabama St Jay FL 32565-1036 | |
| (850) 675-4546 | |
| (850) 675-4548 |
| Full Name | Jeffery S Kelley Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 14088 Alabama St, Jay, Florida |
| Authorized Official Name and Position | Jeffery Scott Kelley (OWNER/PRESIDENT) |
| Authorized Official Contact | 8506754546 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffery S Kelley Md Po Box 10 Jay FL 32565-0010 Ph: (850) 675-4546 | Jeffery S Kelley Md 14088 Alabama St Jay FL 32565-1036 Ph: (850) 675-4546 |
| NPI Number | 1689933467 |
|---|---|
| Provider Enumeration Date | 05/14/2012 |
| Last Update Date | 05/14/2012 |
| Medicare PECOS PAC ID | 7911158712 |
|---|---|
| Medicare Enrollment ID | O20121102000391 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689933467 | NPI | - | NPPES |
| 009952450 | Other | AL | ALACAID |
| 7032394 | Other | AETNA | |
| 59037346 | Other | BLUE CROSS AND BLUE SHIELD OF ALABAMA | |
| 591032244 | Other | CHAMPVA | |
| P00017883 | Other | RAILROAD MEDICARE | |
| 261059100 | Medicaid | FL | |
| 4071564 | Other | CIGNA | |
| A611 | Other | WELLCARE | |
| 05101 | Other | BLUE CROSS AND BLUE SHIELD OF FLORIDA | |
| 1203400 | Other | COVENTRY | |
| 2239990 | Other | UNITED HEALTHCARE | |
| 591032244 | Other | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME81689 (Florida) | Primary |
| Provider Name | Jeffery S Kelley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659334126 PECOS PAC ID: 6709804248 Enrollment ID: I20051103000580 |
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