Individual
DR. CARRIE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1020 JAMESTOWN BLVD, BLDG 200, WATKINSVILLE, GA 30677-4131
(706) 769-0005
Mailing address
PO BOX 48089, STE. A, ATHENS, GA 30604-8089
(706) 769-0005
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
61103
GA
208000000X
Pediatrics Physician
TL28040
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
402113351B
—
GA
Enumeration date
07/17/2006
Last updated
01/18/2016
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