Individual
KELLEY STAFFORD HELQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
714 N DAWSON ST, THOMASVILLE, GA 31792-4451
(904) 252-7761
Mailing address
1473 14TH ST NW, CAIRO, GA 39828-1412
(904) 252-7761
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
063239
GA
2085R0202X
Diagnostic Radiology Physician
ME101757
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000406200
—
FL
Enumeration date
12/15/2006
Last updated
12/17/2009
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