Individual
KELLY LYNN MOORHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
470 WHITE POND DR, SUITE 100, AKRON, OH 44320-1185
(330) 869-8530
(330) 869-8539
Mailing address
470 WHITE POND DR, SUITE 100, AKRON, OH 44320-1185
(330) 869-8530
(330) 869-8539
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35-073029
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
05
—
2269138
—
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
OH
Enumeration date
08/17/2005
Last updated
12/01/2015
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