Mark T Kelly is a General Practice in Pueblo, Colorado. Mark T Kelly practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mark T Kelly is 1578656393. The last update date is 2007-07-09.
Mark T Kelly's current location address is 415 N Grand Ave, Pueblo, Colorado. You can contact this provider via phone number 7195463333. The mailing address for Mark T Kelly is 415 N Grand Ave, Pueblo, Colorado. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark T Kelly |
|---|---|
| Address | 415 N Grand Ave, Pueblo, Colorado |
| Phone Number | 7195463333 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1578656393 |
|---|---|
| Provider Enumeration Date | 2006-10-02 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 415 N Grand Ave |
|---|---|
| City | Pueblo |
| State | Colorado (CO) |
| Post Code | 810033111 |
| Phone Number | 7195463333 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 5869 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1888656 | OK | UNITED CONCORDIA | |
| 200088150A | OK | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Mark T Kelly by the Centers for Medicare & Medicaid Services?
The Mark T Kelly has been issued the NPI (National Provider Identifier) 1578656393, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Mark T Kelly's physical address?
The Mark T Kelly is physically located at 415 N Grand Ave, in the city of Pueblo, CO, with the postal code 810033111.
What is the Mark T Kelly's area of specialization and corresponding taxonomy classification?
The Mark T Kelly's specialty field is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1578656393 to Mark T Kelly?
The Mark T Kelly received its 1578656393 assignment from the Centers for Medicare & Medicaid Services on 2006-10-02.
As of what date were the details related to Mark T Kelly most recently updated or revised?
The information pertaining to Mark T Kelly, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-09.