Jack Leslie Kelley, MD in Lafayette, IN - Surgery

Jack Leslie Kelley, MD is a Surgery physician based in Lafayette, Indiana. Jack Leslie Kelley is licensed to practice in Indiana (license number 01022437A) and his current practice location is 1500 Salem St, Lafayette, Indiana. He can be reached at his office (for appointments etc.) via phone at (765) 448-8000.

NPI number for Jack Leslie Kelley is 1710956065 and his current mailing address is Po Box 5545, Lafayette, Indiana. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710956065.

Contact Information

	Jack Leslie Kelley, MD
	1500 Salem St, Lafayette, IN 47904-2164
	(765) 448-8000
	(765) 448-8337

Physician's Profile

Full Name	Jack Leslie Kelley
Gender	Male
Speciality	Surgery
Location	1500 Salem St, Lafayette, Indiana
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1710956065
Provider Enumeration Date: 03/17/2006
Last Update Date: 07/23/2012

Medical Identifiers

Medical identifiers for Jack Leslie Kelley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1710956065	NPI	-	NPPES
000000197818	Other	IN	ANTHEM PROVIDER NUMBER
KE80251002	Medicaid	IN
100230510	Medicaid	IN
10825369	Other	IN	CAQH NUMBER
9017025	Other	IN	PHCS PID NUMBER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	01022437A (Indiana)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Leslie Kelley is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jack Leslie Kelley, MD Po Box 5545, Lafayette, IN 47903-5545 Ph: (765) 448-8000	Jack Leslie Kelley, MD 1500 Salem St, Lafayette, IN 47904-2164 Ph: (765) 448-8000

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Surgery Doctors in Lafayette, IN

David Halter, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1345 Unity Pl, Suite 235, Lafayette, IN 47905 Phone: 765-446-5065 Fax: 765-446-5170
Richard C Berg Jr., MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-8027
Gerritt F Smith, MD Surgery Medicare: Medicare Enrolled Practice Location: 1701 S Creasy Ln, Lafayette, IN 47905 Phone: 765-423-6690 Fax: 765-423-6691
Dr. Surya Ramachandran Kumar, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5165 Mccarty Ln, Lafayette, IN 47905 Phone: 317-923-1787 Fax: 317-962-0853
Dr. Ruban Nirmalan, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2600 Greenbush St, Lafayette, IN 47904 Phone: 765-448-8000 Fax: 765-448-8027
Dr. Lewis Jeremy Johnson, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3920 St Francis Way Ste 105, Lafayette, IN 47905 Phone: 765-428-1660 Fax: 765-428-1627
John E Francis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1345 Unity Pl, Suite 235, Lafayette, IN 47905 Phone: 765-446-5065 Fax: 765-446-5170

Jack Leslie Kelley, MD - Surgery in Lafayette, IN