| John Kelly, Md, Pllc | |
|
115 S Evans St Tecumseh MI 49286-1949 | |
| (517) 423-9300 | |
| (517) 423-9400 |
| Full Name | John Kelly, Md, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 115 S Evans St, Tecumseh, Michigan |
| Authorized Official Name and Position | John J. Kelly (PHYSICIAN) |
| Authorized Official Contact | 5174239300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Kelly, Md, Pllc 115 S Evans St Tecumseh MI 49286-1949 Ph: (517) 423-9300 | John Kelly, Md, Pllc 115 S Evans St Tecumseh MI 49286-1949 Ph: (517) 423-9300 |
| NPI Number | 1265623748 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 10/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265623748 | NPI | - | NPPES |
| 4970844 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | JK057968 (Michigan) | Primary |
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