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General NPI Number Information
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NPI Number | 1215936158
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Entity Type | Individual
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Provider Name | KELLY JO PARLING-LYNCH DO
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Gender | Female
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Dates
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Enumeration Date | 07/21/2005
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 6425 S. HARVEY ST
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City | NORTON SHORES
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State | MI
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Zip | 49444-9739
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Country | US
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Telephone | 231-737-3469
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Fax | 231-737-4548
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Provider Business Mailing Address
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Address Line | 5800 FOREMOST DR SE STE 300
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-7062
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Country | US
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Telephone | 616-954-9800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 5101014119
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License Number State | MI
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