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NPI Code Detail

MEDICARE: DR. ALYSE MARGARET KELLY-JONES MD

MEDICARE:  DR. ALYSE MARGARET KELLY-JONES  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VG0400XGynecology Physician9900894NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558367680
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALYSE MARGARET KELLY-JONES MD
Provider Business Mailing Address
First Line : 5960 FAIRVIEW RD STE 500
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3113
Country : US
Telephone Number :
Fax Number : 704-495-6324
Provider Business Practice Location Address
First Line : 330 BILLINGSLEY RD STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28211-3096
Country : US
Telephone Number : 704-405-3953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 03/16/2023

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