Provider Demographics
NPI:1336402452
Name:KELLY, ROBERT C (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:KELLY
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Gender:
Credentials:MD
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Mailing Address - Street 1:20 PORTSMOUTH AVE, SUITE 1 #149
Mailing Address - Street 2:
Mailing Address - City:STRATHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03885
Mailing Address - Country:US
Mailing Address - Phone:978-242-7799
Mailing Address - Fax:567-232-3241
Practice Address - Street 1:21 HAMPTON RD BLDG 32ND
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-4831
Practice Address - Country:US
Practice Address - Phone:603-775-0000
Practice Address - Fax:603-755-0247
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2025-03-25
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Provider Licenses
StateLicense IDTaxonomies
NH16913208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3102686Medicaid