Organization
CLEARVISTA RECOVERY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY J KELLY M.D. (OWNER)
(317) 621-7390
Entity
Organization
Contact information
Practice address
7250 CLEARVISTA DR, SUITE 327A, INDIANAPOLIS, IN 46256-4692
(317) 621-7390
(317) 621-4494
Mailing address
7250 CLEARVISTA DR, SUITE 327A, INDIANAPOLIS, IN 46256-4692
(317) 621-7390
(317) 621-4494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01028972
IN
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
01028972
IN
Other
Enumeration date
08/22/2007
Last updated
06/11/2014
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