Individual
WILLIAM E KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8780 PURDUE RD, SUITE 7, INDIANAPOLIS, IN 46268-6129
(317) 471-8701
(317) 471-8702
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01020821A
IN
208C00000X
Colon & Rectal Surgery Physician
01020821
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000173751
ANTHEM
IN
05
—
100317550
—
IN
Enumeration date
01/23/2006
Last updated
04/29/2022
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