| Organization Name: | JON A KELLY DPM |
| NPI Number: | 1144437740 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JON A. KELLY (OWNER AND OPERATOR) |
| Mailing Address: | 1601 Lincoln Way White Oak |
| State: | PA US |
| Postal Code: | 151311720 |
| Phone Number: | 4126739222 |
| Fax Number: | 4126730022 |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 11/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | SC003063L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |