Individual
LISA M TAYLOR KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
35 MILLBURY ST, AUBURN, MA 01501
(508) 832-5917
(508) 832-5751
Mailing address
630 PLANTATION ST, WOT FL 12 ATTN: PHYSICIAN SERVICES, WORCESTER, MA 01605
(508) 368-5529
(508) 368-5530
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
158182
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042472266
HEALTHCARE VALUE MANAGEME
—
01
—
2039829
FIRST HEALTH
—
01
—
3190099
MEDICAID WELFARE
—
05
—
3190099
—
MA
01
—
33744
FALLON COMMUNITY HEALTH P
—
01
—
34378
HEALTHY START
—
01
—
3523062
CIGNA HEALTH PLAN
—
01
—
7166020
AETNA US HEALTHCARE
—
01
—
784202
MVP HEALTH CARE
—
01
—
A28596
MEDICARE B
—
01
—
AA1182
HARVARD PILGRIM HEALTH CA
—
01
—
J19335
BLUE SHIELD INDEMNITY
—
Enumeration date
03/28/2006
Last updated
07/08/2007
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