Individual
KELLY P WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1500 OGLETHORPE AVE STE 500B, ATHENS, GA 30606-2184
(706) 369-5440
Mailing address
1500 OGLETHORPE AVE STE 500B, ATHENS, GA 30606-2184
(706) 369-5440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003050
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139754792A
—
GA
Enumeration date
11/15/2005
Last updated
07/21/2022
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