Anderson, Kelly R

Anderson, Kelly R is an individual health care provider with primary practice located at 520 S 7Th St , Vincennes IN 47591-1038. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Anderson, Kelly R can be contacted via phone (812) 885-3810.

Contact Information

Primary practice address
520 S 7Th St Vincennes IN 47591-1038
Phone: (812) 885-3810
Fax: (812) 885-3811
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 02001311A Indiana

Profile Details

NPI number 1780670828
LBN Legal business name Anderson, Kelly R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Apr 20th, 2018 - about 7 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 1780670828 NPPES
Indiana Other 000000110680 ANTHEM
Indiana MEDICAID 200022500 ANTHEM

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