Kelly, Michael J

Kelly, Michael J is an individual health care provider with primary practice located at 406 N 1St St , Vincennes IN 47591-1340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Michael J can be contacted via phone (812) 885-2750.

Contact Information

Primary practice address
406 N 1St St Vincennes IN 47591-1340
Phone: (812) 885-2750
Fax: (812) 885-2756
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01029257 Indiana

Profile Details

NPI number 1811972128
LBN Legal business name Kelly, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2005
Last updated Jul 21st, 2022 - about 2 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 1811972128 NPPES
Indiana Other 000000668746 ANTHEM
Indiana MEDICAID 100427270 ANTHEM
Indiana Other P00851313 ANTHEM
Indiana Other M400018771 ANTHEM

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