Kelly, John S
Kelly, John S is an individual health care provider with primary practice located at 710 Franklin St Suite 200, Michigan City IN 46360-3563. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Kelly, John S can be contacted via phone (219) 872-6200.Contact Information
Primary practice address
710 Franklin St Suite 200
Michigan City IN 46360-3563
Phone: (219) 872-6200
Fax: (219) 879-2915
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 01024423A | Indiana |
Profile Details
| NPI number | 1033104849 |
|---|---|
| LBN Legal business name | Kelly, John S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Feb 13th, 2024 - about 10 months 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 | 1033104849 | NPPES |
| Indiana | MEDICAID | 200030090 |
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