MEDICARE: CHARLES E KELLY II 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	174400000X	Specialist	40151	TN
2	207RG0100X	Gastroenterology Physician	40151	TN

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	:	1780678979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES E KELLY II MD

Provider Business Mailing Address
First Line	:	2839 HWY 231 NORTH
Second Line	:	SUITE 208A
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-7449
Country	:	US
Telephone Number	:	931-685-8783
Fax Number	:	931-685-8784

Provider Business Practice Location Address
First Line	:	2839 HWY 231 NORTH
Second Line	:	SUITE 208A
City	:	SHELBYVILLE
State	:	TN
Zip	:	37160-7449
Country	:	US
Telephone Number	:	931-685-8783
Fax Number	:	931-685-8784

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

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	03/13/2009

Similar Medicare Providers

1699465138 — LIFESOURCE FAMILY SOLUTIONS CORP
Practice Location Address:

310 COLLOREDO BLVD BLDG B
SHELBYVILLE, TN
37160-2764

Practice Phone: 931-488-4480
Practice Fax:

1609635614 — ONEPERYEAR ENTERPRISES LLC
Practice Location Address:

1305B MADISON ST
SHELBYVILLE, TN
37160-3627

Practice Phone: 256-289-0698
Practice Fax:

1053318923 — DR. BARBARA F KACZMARSKA M.D.
Practice Location Address:

880 COLLOREDO BLVD
SHELBYVILLE, TN
37160-2774

Practice Phone: 931-685-8111
Practice Fax: 931-680-1050

1710985072 — JANIS D EBOLUM APRN-BC
Practice Location Address:

140 DOVER ST
SHELBYVILLE, TN
37160-2776

Practice Phone: 931-684-3426
Practice Fax: 931-684-5860

1316946122 — NAVID MONAJJEM MD
Practice Location Address:

120 FRANK MARTIN RD , SUITE 103
SHELBYVILLE, TN
37160-7194

Practice Phone: 931-684-4074
Practice Fax: 931-684-6992

1003815572 — DANNY L MELSON MD
Practice Location Address:

1701 N MAIN ST , SUITE B
SHELBYVILLE, TN
37160-2303

Practice Phone: 931-684-8686
Practice Fax: 931-684-8687

Directions to “ CHARLES E KELLY II MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.