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General NPI Number Information
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NPI Number | 1891956918
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Entity Type | Organization
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Legal Business Name | GEORGE J KELEN MD PLLC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 913 E LUDINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2437
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Country | US
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Telephone | 231-845-7677
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Fax | 231-843-0773
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Provider Business Mailing Address
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Address Line | 913 E LUDINGTON AVE
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City | LUDINGTON
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State | MI
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Zip | 49431-2437
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Country | US
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Telephone | 231-845-7677
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Fax | 231-843-0773
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE JOHN KELEN
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Credential | MD, FACC
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Telephone | 231-845-7677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 4301079843
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License Number State | MI
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