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Kelli R Hickle, MD
Plastic and Reconstructive Surgery Physician in South Portland, Maine
NPI 1013303544

Kelli R Hickle is a Plastic and Reconstructive Surgery Physician based in South Portland, ME and is specialized in Plastic and Reconstructive Surgery. Kelli R Hickle practices in South Portland, ME and has the professional credentials of MD. The NPI Number for Kelli R Hickle is 1013303544 and holds a License No. 273850 (Maine).

The current practice location address for Kelli R Hickle is 244 Western Ave # 100, South Portland, ME and can be reached out via phone at 207-775-3446.

Location: 244 Western Ave # 100, South Portland, ME, 04106-2430
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Provider Profile Details
NPI Number
1013303544
Provider Name
Kelli R Hickle
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
244 Western Ave # 100, South Portland, ME, 04106-2430
Phone Number
207-775-3446
Fax Number
Provider Enumeration Date
04/10/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MD25330 01 ME MAINE MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
244 Western Ave # 100
City
State
Zip
04106-2496
Phone Number
207-775-3446
Fax Number
person
Provider Business Mailing Address Details
Address
244 Western Ave # 100
City
State
Zip
04106-2496
Phone Number
207-775-3446
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Plastic and Reconstructive Surgery
Taxonomy
License No.
()
Definition
A surgeon who specializes in plastic and reconstructive surgery.
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Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
License No.
273850 (Massachusetts)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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