Provider Demographics
NPI:1134575160
Name:BROWN-JEANBART, KELLY JO (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:JO
Last Name:BROWN-JEANBART
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:115 MILL ST
Mailing Address - Street 2:C/O KELLY BROWN-JEANBART, MAILSTOP 222
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478-1064
Mailing Address - Country:US
Mailing Address - Phone:617-855-3433
Mailing Address - Fax:
Practice Address - Street 1:115 MILL ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1064
Practice Address - Country:US
Practice Address - Phone:617-855-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-09
Last Update Date:2024-06-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2952322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry