Individual
LAWRENCE R KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3906 S DUPONT SQ, LOUISVILLE, KY 40207-4647
(812) 282-3899
(812) 282-4172
Mailing address
101 HOSPITAL BLVD, JEFFERSONVILLE, IN 47130-3769
(812) 282-3899
(812) 282-4172
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01066513A
IN
2085R0202X
Diagnostic Radiology Physician
42926
KY
2085R0202X
Diagnostic Radiology Physician
R0569
KY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
42926
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122620057
MEDICARE
IN
05
—
2004551630
—
IN
05
—
7100071920
—
KY
01
—
K0027182
MEDICARE
KY
Enumeration date
03/08/2007
Last updated
01/20/2026
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