Individual
MR. RICHARD ALLAN KERESEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
5603 W RAYMOND, SUITE A, INDIANAPOLIS, IN 46241-4356
(317) 241-8266
(317) 247-4978
Mailing address
4850 W CENTURY PLAZA RD, INDIANAPOLIS, IN 46254
(317) 216-2828
(317) 216-2839
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000012A
IN
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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