Individual
DR. JOHN E KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
250 HAMPTON ST, AUBURN, MA 01501-2584
(508) 753-2060
(508) 752-4244
Mailing address
250 HAMPTON ST, AUBURN, MA 01501-2584
(508) 753-2060
(508) 752-4244
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43538
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110000875A
—
MA
01
—
190882
CIGNA
MA
01
—
4406
FALLON HEALTH INS #
MA
01
—
64109
HARVARD PILGRIM ID #
MA
01
—
710456
TUFTS
MA
01
—
99995302
NETWORK HEALTH ID #
MA
01
—
N01871
BLUE SHIELD ID #
MA
Enumeration date
02/28/2006
Last updated
04/13/2011
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