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Organization

PENNY W. KALLMYER, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PENNY KALLMYER M.D. (M.D.)
(317) 291-5190
Entity
Organization

Contact information

Practice address
6640 PARKDALE PL, SUITE U, INDIANAPOLIS, IN 46254-5619
(317) 291-5190
(317) 291-1510
Mailing address
6640 PARKDALE PL, SUITE U, INDIANAPOLIS, IN 46254-5619
(317) 291-5190
(317) 291-1510

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01041481
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200010530B
IN
Enumeration date
02/24/2012
Last updated
02/24/2012
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