Individual
GERALD T KITCHENS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-0275
(317) 274-0256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01051645A
IN
207L00000X
Anesthesiology Physician
30278
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104606113
ANTHEM PTAN
IN
05
—
692790
—
AZ
Enumeration date
06/11/2006
Last updated
01/08/2025
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