Organization
FAMILY MEDICINE OF VINCENNES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J KELLY (PRESIDENT)
(812) 895-8000
Entity
Organization
Contact information
Practice address
328 N 2ND ST, STE 205, VINCENNES, IN 47591
(812) 895-8000
(812) 895-8006
Mailing address
328 N 2ND ST, STE 205, VINCENNES, IN 47591
(812) 895-8000
(812) 895-8006
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA2679
RAILROAD MEDICARE
IN
Enumeration date
01/04/2008
Last updated
02/25/2008
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