Provider Demographics
NPI:1083795157
Name:CAIN, KELLY H (DO)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:H
Last Name:CAIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DARTMOUTH HITCHCOCK MEDICAL CENTER
Mailing Address - Street 2:1 MEDICAL CENTER DR
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03765
Mailing Address - Country:US
Mailing Address - Phone:603-650-5000
Mailing Address - Fax:
Practice Address - Street 1:DARTMOUTH HITCHCOCK MEDICAL CENTER
Practice Address - Street 2:1 MEDICAL CENTER DR
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03765
Practice Address - Country:US
Practice Address - Phone:603-650-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHRT 1322207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology