Individual
DR. KEITH NALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4111 FRANKLIN ST, MICHIGAN CITY, IN 46360-7803
(219) 873-2919
(219) 873-2909
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002091A
IN
208D00000X
General Practice Physician
02002091A
IN
Other
Enumeration date
01/30/2007
Last updated
11/20/2023
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