Healthcare Provider Details

I. General information

NPI: 1073586335
Provider Name (Legal Business Name): DAVID C KAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 03/18/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 DORCHESTER CT SUITE 2
GOSHEN IN
46526-6534
US

IV. Provider business mailing address

2024 DORCHESTER CT SUITE 2
GOSHEN IN
46526-6534
US

V. Phone/Fax

Practice location:
  • Phone: 574-537-1626
  • Fax: 574-364-2939
Mailing address:
  • Phone: 574-537-1626
  • Fax: 574-364-2939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01039597A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: