Jones, Kelly N
Jones, Kelly N is an individual health care provider with primary practice located at 1512 N Green Mount Rd , O Fallon IL 62269-1953. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obesity Medicine. Allopathic & Osteopathic Physicians / Obesity Medicine is her primary health care specialty. Jones, Kelly N can be contacted via phone (618) 624-3750.Contact Information
Primary practice address
1512 N Green Mount Rd
O Fallon IL 62269-1953
Phone: (618) 624-3750
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036-116148 | Illinois |
| Allopathic & Osteopathic Physicians / Obesity Medicine | 207QB0002X | 036116148 | Illinois |
Profile Details
| NPI number | 1417057779 |
|---|---|
| LBN Legal business name | Jones, Kelly N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Feb 7th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417057779 | NPPES |
| Illinois | MEDICAID | 036116148 | |
| Illinois | Other | P00369032 | |
| Illinois | Other | 08232205 |
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