Michael J. Kelly Md | |
308 Main St Lakeville CT 06039-1204 | |
(860) 435-3551 | |
(860) 435-3561 |
Full Name | Michael J. Kelly Md |
---|---|
Speciality | Internal Medicine |
Location | 308 Main St, Lakeville, Connecticut |
Authorized Official Name and Position | Michael J Kelly (OWNER) |
Authorized Official Contact | 8604353551 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Michael J. Kelly Md Po Box 1748 Lakeville CT 06039-1748 Ph: (860) 435-3551 | Michael J. Kelly Md 308 Main St Lakeville CT 06039-1204 Ph: (860) 435-3551 |
NPI Number | 1376703751 |
---|---|
Provider Enumeration Date | 06/10/2008 |
Last Update Date | 06/10/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376703751 | NPI | - | NPPES |
001417270 | Medicaid | CT | |
1124102546 | Other | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 041727 (Connecticut) | Primary |