John Kelly, MD, PLLC
Family Medicine in Tecumseh, MI. Organization (NPI-2).
NPI number1265623748
StatusActive
Last updated in NPPESOct 23, 2014
Details
- NPI
- 1265623748
- Entity type
- Organization (NPI-2)
- Legal business name
- John Kelly, MD, PLLC
- Organization subpart
- No
- Enumeration date
- Aug 8, 2007
- Last updated
- Oct 23, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | JK057968 | MI | Yes |
Practice location
115 S Evans StTecumseh, MI 49286-1949
Phone 517-423-9300 · Fax 517-423-9400
Mailing address
115 S Evans StTecumseh, MI 49286-1949
Phone 517-423-9300 · Fax 517-423-9400
Authorized official
John J. Kelly
Physician
5174239300
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