Kevin J Kelly, MD
Internal Medicine, Cardiovascular Disease in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1982606315
StatusActive
Last updated in NPPESNov 29, 2016
Details
- NPI
- 1982606315
- Entity type
- Individual (NPI-1)
- Name
- Kevin J Kelly
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 15, 2005
- Last updated
- Nov 29, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RC0000X | Internal Medicine, Cardiovascular Disease | 01032406A | IN | Yes |
Practice location
11108 Parkview Circle DrFort Wayne, IN 46845-1730
Phone 260-266-5700 · Fax 260-266-5920
Mailing address
3926 New Vision DrSuite 1
Fort Wayne, IN 46845-1712
Phone 260-373-9705 · Fax 260-373-9705
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