Kelly, Russell Aaron

Kelly, Russell Aaron is an individual health care provider with primary practice located at 103 Myron St Suite A, West Springfield MA 01089-1598. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Kelly, Russell Aaron can be contacted via phone (413) 592-1980.

Contact Information

Primary practice address
103 Myron St Suite A West Springfield MA 01089-1598
Phone: (413) 592-1980
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1762 Massachusetts

Profile Details

NPI number 1043316532
LBN Legal business name Kelly, Russell Aaron
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Mar 14th, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1043316532 NPPES
Massachusetts Other 0009706 MEDICARE PTAN

Popular Providers