Individual
DR. KELLY LORRAINE PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4141 SHORE DRIVE, INDIANAPOLIS, IN 46254
(317) 329-2525
(317) 329-2360
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01061527A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010251
MEDICARE
IN
05
—
200903600
—
IN
Enumeration date
04/28/2008
Last updated
12/23/2020
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