Kelly, Mark

Kelly, Mark is an individual health care provider with primary practice located at 85 Spring St , Laconia NH 03246-3113. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngic Allergy, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Kelly, Mark can be contacted via phone (603) 524-7402.

Contact Information

Primary practice address
85 Spring St Laconia NH 03246-3113
Phone: (603) 524-7402
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 11416 New Hampshire
Allopathic & Osteopathic Physicians / Otolaryngic Allergy 207YX0602X 11416 New Hampshire
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 11416 New Hampshire

Profile Details

NPI number 1427016633
LBN Legal business name Kelly, Mark
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Aug 31st, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427016633 NPPES
New Hampshire MEDICAID 30201594
New Hampshire MEDICAID 3077628

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