Individual
PATRICK SEAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
803 POPLAR ST, MURRAY, KY 42071-2432
(270) 762-1100
Mailing address
1000 S 12TH ST, MURRAY, KY 42071-9303
(270) 759-9200
(270) 759-9966
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32195
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050312
ANTHEM PROVIDER NUMBER
KY
01
—
110168896
RAILROAD MEDICARE PROV NO
KY
05
—
64321953
—
KY
Enumeration date
11/17/2005
Last updated
08/02/2023
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