Reckley, Kevin Patrick

Reckley, Kevin Patrick is an sole proprietor health care provider with primary practice located at 5611 S Meridian St , Indianapolis IN 46217-3750. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Reckley, Kevin Patrick can be contacted via phone (317) 781-9090.

Contact Information

Primary practice address
5611 S Meridian St Indianapolis IN 46217-3750
Phone: (317) 781-9090
Fax: (317) 782-3937
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 18002071B Indiana

Profile Details

NPI number 1295705218
LBN Legal business name Reckley, Kevin Patrick
Credentials KEVIN RECKLEY O.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2006
Last updated Feb 9th, 2011 - about 15 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 1295705218 NPPES
Indiana MEDICAID 100277610A

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