Kelly, Kevin Joseph

Kelly, Kevin Joseph 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, Kevin Joseph 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 26462 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35055413 Ohio

Profile Details

NPI number 1417920554
LBN Legal business name Kelly, Kevin Joseph
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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417920554 NPPES
Other 000000033787 ANTHEM
MEDICAID 64264625 ANTHEM
Other 1220585 ANTHEM
Other 0637293 ANTHEM

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