Individual
JEFFREY J KELLAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
850 N MERIDIAN ST, INDIANAPOLIS, IN 46204-1098
(317) 554-2710
Mailing address
250 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46219-4959
(317) 962-3834
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
01023914
IN
2084P0800X
Psychiatry Physician
Primary
01023914A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100319000
—
IN
Enumeration date
06/03/2006
Last updated
11/25/2020
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