MEDICARE: FRANK J. KELLY II MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VX0201X	Gynecologic Oncology Physician	00019355	AL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00603054	OTHER	AL	RR MEDICARE
12	CA0084	OTHER	AL	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2230930	OTHER	AL	FIRST HEALTH PROVIDER #
4	515-35231	OTHER	AL	BCBS OF AL
5	5492768	OTHER	AL	CCN PROVIDER NUMBER
6	510-50070	OTHER	AL	BCBS OF ALABAMA
7	515-19377	OTHER	AL	BCBS OF AL PROVIDER #
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	DD6388	OTHER	AL	RAILROAD MCARE PROV. #
10	G38565	OTHER	AL	VIVA HEALTH PROVIDER #
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	7008083	OTHER	AL	AETNA PROVIDER NUMBER

NPI Number	:	1306831243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK J. KELLY II MD

Provider Business Mailing Address
First Line	:	PO BOX 2705
Second Line	:	STE 220
City	:	HUNTSVILLE
State	:	AL
Zip	:	35804-2705
Country	:	US
Telephone Number	:	256-801-6048
Fax Number	:	256-801-6218

Provider Business Practice Location Address
First Line	:	201 SIVLEY RD SW
Second Line	:	SUITE 620
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5134
Country	:	US
Telephone Number	:	256-265-4600
Fax Number	:	256-265-4651

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	01/11/2017

201 SIVLEY RD SW
HUNTSVILLE, AL
35801-5134

Practice Phone: 256-265-2895
Practice Fax: