Individual
DR. SCOTT A. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6635 LAKE DR, MORROW, GA 30260-2354
(770) 968-1323
(770) 968-4556
Mailing address
6635 LAKE DR, MORROW, GA 30260-2354
(770) 968-1323
(770) 968-4556
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
044256
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000955787A
—
GA
05
—
000955787D
—
GA
05
—
000955787F
—
GA
Enumeration date
09/30/2005
Last updated
03/28/2008
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