Individual
KENNETH BECKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8330 NAAB RD, SUITE 234, INDIANAPOLIS, IN 46260-5925
(317) 875-0084
(317) 876-5580
Mailing address
8935 N MERIDIAN ST, SUITE 200, INDIANAPOLIS, IN 46260-5379
(317) 564-2132
(317) 574-4737
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01028542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100368000
—
IN
Enumeration date
09/16/2005
Last updated
07/22/2008
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