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Individual

JOHN KING CELLETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1850 STATE ST, NEW ALBANY, IN 47150-4990
(812) 948-6742
Mailing address
1919 STATE ST STE 324, NEW ALBANY, IN 47150-6807
(812) 945-7536
(812) 945-7542

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
01031466
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000059445
BLUE SHIELD
IN
01
I007921
CHAMPUS
IN
Enumeration date
07/07/2006
Last updated
07/08/2007
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