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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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