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NPI Code Detail

MEDICARE: PATRICK SEAN KELLY MD

MEDICARE: PATRICK SEAN KELLY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician32195KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3110168896OTHERKYRAILROAD MEDICARE PROV NO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000050312OTHERKYANTHEM PROVIDER NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598747396
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK SEAN KELLY MD
Provider Business Mailing Address
First Line : 1000 S 12TH ST
Second Line :
City : MURRAY
State : KY
Zip : 42071-9303
Country : US
Telephone Number : 270-759-9200
Fax Number : 270-759-9966
Provider Business Practice Location Address
First Line : 803 POPLAR ST
Second Line :
City : MURRAY
State : KY
Zip : 42071-2432
Country : US
Telephone Number : 270-762-1100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 08/02/2023

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Directions to “ PATRICK SEAN KELLY MD” Practice Location

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