Kelly, Marc Stephen

Kelly, Marc Stephen is an individual health care provider with primary practice located at 1400 E Boulder St , Colorado Springs CO 80909-5533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Kelly, Marc Stephen can be contacted via phone (719) 457-6200.

Contact Information

Primary practice address
1400 E Boulder St Colorado Springs CO 80909-5533
Phone: (719) 457-6200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 40518 Colorado

Profile Details

NPI number 1942359344
LBN Legal business name Kelly, Marc Stephen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 1st, 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 1942359344 NPPES
Colorado MEDICAID 9000152750

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