| Doctor Name: | JEFFREY D KELLOGG |
| NPI Number: | 1861532350 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 15594 |
| Business Practice Address: | 45 Maddex Dr Shepherdstown, WV - 254434322 |
| Business Phone Number: | 3048769321 |
| Business Fax Number: | 3048761481 |
| Mailing Address: | Po Box 1880, SHEPHERDSTOWN |
| State: | WV |
| Postal Code: | 254431880 |
| Phone Number: | 3048769321 |
| Fax Number: | 3048761481 |
| NPI Enumeration Date: | 02/07/2007 |
| NPI Last Update Date: | 05/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0000X |
| License Number: | 15594 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WV |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. |