Provider Demographics
NPI:1609072123
Name:METZ, KELLY ALLRED (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ALLRED
Last Name:METZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9800 SHELBYVILLE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2992
Mailing Address - Country:US
Mailing Address - Phone:502-429-8585
Mailing Address - Fax:502-429-6157
Practice Address - Street 1:8250 KENWOOD CROSSING WAY STE 200
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3669
Practice Address - Country:US
Practice Address - Phone:513-275-0847
Practice Address - Fax:855-656-7325
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.089311207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2789246Medicaid
OH2789246Medicaid
OHH208220Medicare PIN