Healthcare Provider Details

I. General information

NPI: 1821731381
Provider Name (Legal Business Name): KELLY ELIZABETH FLANAGAN MD MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 LINCOLN ST
WORCESTER MA
01605-2138
US

IV. Provider business mailing address

PO BOX 415348
BOSTON MA
02241-5348
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-5979
  • Fax: 508-334-5232
Mailing address:
  • Phone: 800-225-8885
  • Fax: 508-334-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number1027673
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: