| Dr Jeffrey John Kelly, DO | |
|
3643 W Front St, Suite A, Traverse City, MI 49684-7759 | |
| (231) 935-0620 | |
| (231) 935-0626 |
| Full Name | Dr Jeffrey John Kelly |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Experience | 15 Years |
| Location | 3643 W Front St, Traverse City, Michigan |
| 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 |
|---|---|---|---|
| 1770565384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 055534 (Georgia) | Secondary |
| 207N00000X | Dermatology | 5101020217 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Medical Center | Traverse city, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Associates In Dermatology Of Traverse City Pc | 4981607298 | 5 |
| Entity Name | Associates In Dermatology Of Traverse City Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861430779 PECOS PAC ID: 4981607298 Enrollment ID: O20060804000316 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jeffrey John Kelly, DO 3643 W Front St, Suite A, Traverse City, MI 49684-7759 Ph: (231) 935-0620 | Dr Jeffrey John Kelly, DO 3643 W Front St, Suite A, Traverse City, MI 49684-7759 Ph: (231) 935-0620 |
Raymond J Dean, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3643 W Front St Ste A, Traverse City, MI 49684 Phone: 231-935-0620 Fax: 231-935-0626 | |
Paula L Cahill, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 550 Munson Ave, Suite 200, Traverse City, MI 49686 Phone: 231-935-8717 Fax: 231-935-9230 | |
Maria C Carroll, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 550 Munson Ave, Suite 200, Traverse City, MI 49686 Phone: 231-935-8717 Fax: 231-935-9230 | |
Joan M Griner Licht, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3643 W Front St Ste A, Traverse City, MI 49684 Phone: 231-935-0620 Fax: 231-935-0626 | |
Susan C Noble, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 550 Munson Avenue, Suite 200, Traverse City, MI 49686 Phone: 231-935-8717 Fax: 231-935-9230 | |
Anthony C Vanvreede, Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1225 W Front St Ste C, Traverse City, MI 49684 Phone: 231-642-5031 Fax: 231-525-2306 |