Kelly, Timothy Joseph

Kelly, Timothy Joseph is an individual health care provider with primary practice located at 7165 Clearvista Way , Indianapolis IN 46256-4621. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Kelly, Timothy Joseph can be contacted via phone (317) 621-5100.

Contact Information

Primary practice address
7165 Clearvista Way Indianapolis IN 46256-4621
Phone: (317) 621-5100
Fax: (317) 621-7896
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 01028972 Indiana
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 01028972 Indiana

Profile Details

NPI number 1730297748
LBN Legal business name Kelly, Timothy Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Nov 27th, 2023 - about 3 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 1730297748 NPPES
Indiana Other 000000872285 ANTHEM
Indiana Other 000000078852 ANTHEM
Indiana MEDICAID 100333150 ANTHEM
Indiana Other 000000871759 ANTHEM
Indiana Other 000000871726 ANTHEM

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