Hickle, Kelli R

Hickle, Kelli R is an individual health care provider with primary practice located at 244 Western Ave # 100 , South Portland ME 04106-2496. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is her primary health care specialty. Hickle, Kelli R can be contacted via phone (207) 775-3446.

Contact Information

Primary practice address
244 Western Ave # 100 South Portland ME 04106-2496
Phone: (207) 775-3446
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 273850 Massachusetts
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X MD25330 Maine

Profile Details

NPI number 1013303544
LBN Legal business name Hickle, Kelli R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2015
Last updated Apr 10th, 2023 - about 3 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 1013303544 NPPES
Maine Other MD25330 MAINE MEDICAL LICENSE

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