Kelly, Kevin J

Kelly, Kevin J is an individual health care provider with primary practice located at 11108 Parkview Circle Dr , Fort Wayne IN 46845-1730. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Kelly, Kevin J can be contacted via phone (260) 266-5700.

Contact Information

Primary practice address
11108 Parkview Circle Dr Fort Wayne IN 46845-1730
Phone: (260) 266-5700
Fax: (260) 266-5920
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 01032406A Indiana

Profile Details

NPI number 1982606315
LBN Legal business name Kelly, Kevin J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Nov 29th, 2016 - about 10 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 1982606315 NPPES
Ohio Other 060071114 RR MEDICARE
Ohio Other 06199 RR MEDICARE
Ohio Other P00786817 RR MEDICARE
Ohio Other P00846125 RR MEDICARE
Ohio Other 000000641087 RR MEDICARE
Ohio MEDICAID 100360760 RR MEDICARE
Ohio MEDICAID 0522401 RR MEDICARE
Ohio Other 060070567 RR MEDICARE

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