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1295705416

NPI Code Detail

MEDICARE: WILLIAM E KELLEY MD

MEDICARE: WILLIAM E KELLEY 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
1	208C00000X	Colon & Rectal Surgery Physician	01020821	IN
2	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	01020821A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000173751	OTHER	IN	ANTHEM

General Provider Information

NPI Number	:	1295705416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM E KELLEY MD

Provider Business Mailing Address
First Line	:	6626 E 75TH ST
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8780 PURDUE RD
Second Line	:	SUITE 7
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-6129
Country	:	US
Telephone Number	:	317-471-8701
Fax Number	:	317-471-8702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	04/29/2022

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1811030885 — DR. MARILYN J DARGIS M.D.
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Directions to “ WILLIAM E KELLEY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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