Individual
RICHARD S KELTNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
482 S LIBERTY DR, BLOOMINGTON, IN 47403-1927
(812) 353-3443
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(317) 963-4171
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000536A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340099
BLUE CROSS/BLUE SHIELD
IN
01
—
000000626065
ANTHEM BC/BS
IN
01
—
000000659907
ANTHEM BC/BS
IN
01
—
970021354
RAILROAD MEDICARE
IN
01
—
P00775296
RAILROAD MEDICARE
IN
01
—
P00841047
RAILROAD MEDICARE
IN
Enumeration date
07/21/2005
Last updated
10/17/2025
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