| Mr Owen L Kelly, MD | |
|
401 N Phoenix Ave, Russellville, AR 72801-2844 | |
| (479) 890-5355 | |
| (479) 890-5366 |
| Full Name | Mr Owen L Kelly |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 27 Years |
| Location | 401 N Phoenix Ave, Russellville, Arkansas |
| 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 |
|---|---|---|---|
| 1962461707 | NPI | - | NPPES |
| 182582002 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | E3477 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Marys Regional Medical Center | Russellville, AR | Hospital |
| Johnson Regional Medical Center | Clarksville, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Marys Physician Services Llc | 4981698032 | 40 |
| Entity Name | St Marys Physician Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124084991 PECOS PAC ID: 4981698032 Enrollment ID: O20040609000759 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Owen L Kelly, MD Po Box 690, Russellville, AR 72811-1146 Ph: (479) 890-5355 | Mr Owen L Kelly, MD 401 N Phoenix Ave, Russellville, AR 72801-2844 Ph: (479) 890-5355 |
Dr. Mark Edward Buchanan, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 101 Skyline Dr, Russellville, AR 72801 Phone: 479-968-2345 Fax: 479-890-2497 | |
Jefferson Cartwright, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 101 Skyline Dr, Russellville, AR 72801 Phone: 479-968-2345 Fax: 479-890-2497 | |
Dr. Ted Honghiran, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 2504 West Main St, Suite A, Russellville, AR 72801 Phone: 479-968-3200 | |
W Bruce Brown, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 3016 W Main St, Russellville, AR 72801 Phone: 479-890-2663 Fax: 479-880-2663 |