Individual
EMILY MARIE KISOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1627 E BRISTOL ST, ELKHART, IN 46514-3817
(574) 262-0313
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
(574) 647-3725
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01076081
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201354790
—
IN
Enumeration date
04/04/2013
Last updated
08/12/2025
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