MEDICARE: DR. FRANCIS WILLIAM KELLY JR. 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
1	207Q00000X	Family Medicine Physician	181785	NY

Other Identifiers

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

General Provider Information

NPI Number	:	1487674115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCIS WILLIAM KELLY JR. MD

Provider Business Mailing Address
First Line	:	2261 STATE ROUTE 19 N
Second Line	:
City	:	WARSAW
State	:	NY
Zip	:	14569-9334
Country	:	US
Telephone Number	:	585-786-2010
Fax Number	:	585-786-2058

Provider Business Practice Location Address
First Line	:	2261 STATE ROUTE 19 N
Second Line	:
City	:	WARSAW
State	:	NY
Zip	:	14569-9334
Country	:	US
Telephone Number	:	585-786-2010
Fax Number	:	585-786-2058

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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