It looks like Kelley's head photoshopped onto a stock image of a magician.
Edit: Yup, found the magician. Now to see if I can find where that headshot is from. It's definitely TOS era.
Edit 2: Couldn't find it with a simple reverse image search, so I looked for "DeForest Kelley smiling" and found the original image of him on this delightfully old-school web page dating back to 2001. (Bless him, the page is still active and has a counter and everything.) The image makes it clear that it is indeed from Star Trek, but he has on a unique formal looking tunic with a split collar, which should make it easy to narrow down to a specific episode.
Edit 3: Some reverse image searching on the full image led me to the ever-useful site getyarn.io, which provided a clip of the exact moment of this image, in which Bones is saying "a teddy bear?" It's from TOS S02E10, "Journey to Babel". Here's a longer clip with the amusing context: