Individual
KEVIN T KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
46 NORTH ST, HYANNIS, MA 02601-3845
(508) 862-5680
(508) 862-7984
Mailing address
46 NORTH ST, HYANNIS, MA 02601-3845
(508) 862-5680
(508) 862-7984
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
10523
MT
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
220264
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0141154
—
MA
05
—
0141154
—
MT
Enumeration date
09/21/2005
Last updated
07/12/2011
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