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Individual

GORDON R KELLY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
254 STRATTON RD, RUTLAND, VT 05701
(802) 775-0038
(802) 747-0602
Mailing address
254 STRATTON RD, GORDON R KELLY MD, RUTLAND, VT 05701
(802) 775-0038
(802) 747-0602

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0420004097
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0004346
VT
Enumeration date
02/14/2006
Last updated
07/08/2007
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