| Russell S Kelly Md Llc | |
|
91-2139 Fort Weaver Rd Suite 300 Ewa Beach HI 96706-3607 | |
| (808) 678-0700 | |
| (808) 678-0776 |
| Full Name | Russell S Kelly Md Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 91-2139 Fort Weaver Rd, Ewa Beach, Hawaii |
| Authorized Official Name and Position | Russell S Kelly (PHYSICIAN) |
| Authorized Official Contact | 8086780700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell S Kelly Md Llc 91-2139 Fort Weaver Rd Suite 300 Ewa Beach HI 96706-3607 Ph: (808) 678-0700 | Russell S Kelly Md Llc 91-2139 Fort Weaver Rd Suite 300 Ewa Beach HI 96706-3607 Ph: (808) 678-0700 |
| NPI Number | 1598810814 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 02/06/2008 |
| Medicare PECOS PAC ID | 2365548781 |
|---|---|
| Medicare Enrollment ID | O20070502000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598810814 | NPI | - | NPPES |
| 0000241885 | Medicaid | HI | |
| 53920701 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 11807 (Hawaii) | Primary |
| Provider Name | Russell S Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790787729 PECOS PAC ID: 5092760017 Enrollment ID: I20070322000144 |
| Provider Name | Jasmine M Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871090845 PECOS PAC ID: 6103179411 Enrollment ID: I20210916001893 |
James M Warner Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-2141 Fort Weaver Rd, Ewa Beach, HI 96706 Phone: 808-678-7370 Fax: 808-678-7240 | |
Drt Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-2141 Fort Weaver Rd, Ewa Beach, HI 96706 Phone: 808-678-7000 | |
Empower Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 91-6390 Kapolei Pkwy, Ewa Beach, HI 96706 Phone: 808-691-4600 | |
Access Medical Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 91-1401 Fort Weaver Rd, Ewa Beach, HI 96706 Phone: 808-285-2448 | |
West Oahu Acupuncture And Integrative Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-1123 Keaunui Dr Ste 223, Ewa Beach, HI 96706 Phone: 808-638-4559 Fax: 781-998-2412 | |
Waianae District Comprehensive Health And Hospital Board, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-1841 Fort Weaver Rd, Ewa Beach, HI 96706 Phone: 808-697-3300 | |
Rachel Tortolini Md,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 91-896 Makule Rd Ste 102, Ewa Beach, HI 96706 Phone: 808-689-4414 Fax: 808-689-7115 |