Individual
DR. KELLY M MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
505 W HOLLIS ST, NASHUA, NH 03062-1358
(603) 882-0311
(603) 386-0046
Mailing address
505 W HOLLIS ST, NASHUA, NH 03062-1358
(603) 882-0311
(603) 386-0046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0721
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30352338
—
NH
01
—
7720
AETNA
—
Enumeration date
11/14/2006
Last updated
01/08/2020
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