Lillemoe, Keith D

Lillemoe, Keith D is an individual health care provider with primary practice located at 545 Barnhill Dr Em 523, Indianapolis IN 46202-5112. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Lillemoe, Keith D can be contacted via phone (317) 274-3086.

Contact Information

Primary practice address
545 Barnhill Dr Em 523 Indianapolis IN 46202-5112
Phone: (317) 274-3086
Fax: (317) 278-1886
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1058276A Indiana
Allopathic & Osteopathic Physicians / Surgery 208600000X 247458 Massachusetts

Profile Details

NPI number 1215982467
LBN Legal business name Lillemoe, Keith D
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Jun 16th, 2011 - about 15 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 1215982467 NPPES
Indiana MEDICAID 200460210

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