Kelly, Charles Jude

Kelly, Charles Jude is an individual health care provider with primary practice located at 20 Medical Village Dr Suite 102, Edgewood KY 41017-5401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Kelly, Charles Jude can be contacted via phone (859) 341-1011.

Contact Information

Primary practice address
20 Medical Village Dr Suite 102 Edgewood KY 41017-5401
Phone: (859) 341-1011
Fax: (859) 341-7198
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 34229 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35 07 8628 Ohio

Profile Details

NPI number 1972576098
LBN Legal business name Kelly, Charles Jude
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Jul 8th, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1972576098 NPPES
Other 7499170002 CIGNA
Other 1202784 CIGNA
Other 2501317 CIGNA
Other 000000175988 CIGNA
MEDICAID 64013543 CIGNA

Popular Providers