Kelly, James Patrick

Kelly, James Patrick is an sole proprietor health care provider with primary practice located at 17022 Shandwick Lane , Granger IN 46530. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Kelly, James Patrick can be contacted via phone (574) 277-9156.

Contact Information

Primary practice address
17022 Shandwick Lane Granger IN 46530
Phone: (574) 277-9156
Fax: (574) 271-5639
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 01034778 Indiana
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 1034778A Indiana

Profile Details

NPI number 1174608442
LBN Legal business name Kelly, James Patrick
Credentials MD, MBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 26th, 2006
Last updated Jan 15th, 2016 - about 9 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 1174608442 NPPES
Indiana MEDICAID 100193010A

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