Bailey, Kelly Neidiffer

Bailey, Kelly Neidiffer is an individual health care provider with primary practice located at 4326 Charlestown Rd , New Albany IN 47150-9568. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Bailey, Kelly Neidiffer can be contacted via phone (812) 945-0023.

Contact Information

Primary practice address
4326 Charlestown Rd New Albany IN 47150-9568
Phone: (812) 945-0023
Fax: (812) 945-0291
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18003232A Indiana
Eye and Vision Services Providers / Optometrist 152W00000X 1594 DT Kentucky

Profile Details

NPI number 1225020365
LBN Legal business name Bailey, Kelly Neidiffer
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Sep 25th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225020365 NPPES
Indiana Other 000000350868 ANTHEM BCBS
Indiana Other 18003232A ANTHEM BCBS
Indiana Other 1594DT ANTHEM BCBS
Indiana MEDICAID 200470620 ANTHEM BCBS
Indiana Other P00191799 ANTHEM BCBS

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