| 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 |