Individual
MR. JAMES PATRICK KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MBA
Contact information
Practice address
17022 SHANDWICK LANE, GRANGER, IN 46530
(574) 277-9156
(574) 271-5639
Mailing address
17022 SHANDWICK LANE, GRANGER, IN 46530
(574) 277-9156
(574) 271-5639
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01034778
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
1034778A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100193010A
—
IN
Enumeration date
10/26/2006
Last updated
01/15/2016
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