John S Kelly
Geriatric Medicine
710 Franklin St Suite 200
Michigan City
, Indiana 46360-3563
John S Kelly
Geriatric Medicine
710 Franklin St Suite 200
Michigan City
, Indiana 46360-3563
(219) 864-2649
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About
Features
Specialties
- Geriatric Medicine
Languages spoken
- English
Location
First Address
- John S Kelly
- Po Box 2000
- Dyer, IN
- Zip : 46311-0900
- Fax : (219) 864-2649
- Phone : (219) 864-2107
Second Address
- John S Kelly
- 710 Franklin St Suite 200
- Michigan City, IN
- Zip : 46360-3563
- Fax : (219) 879-2915
- Phone : (219) 872-6200
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0300X | Geriatric Medicine | 01024423A | IN |
National Provider Identifier
| NPI | 1033104849 |
|---|---|
| Provider Name | John S Kelly |
| First Address | Dyer, IN 46311-0900 |
| Second Address | Michigan City, IN 46360-3563 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/09/2005 |
| Last Update Date | 24/02/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 200030090 | (05) | IN |
| D69721 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.