Individual
NICHOLAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1558 RIVERSTONE PKWY STE 100, CANTON, GA 30114-2888
(404) 785-5437
(404) 785-4683
Mailing address
1558 RIVERSTONE PKWY STE 100, CANTON, GA 30114-2888
(404) 785-5437
(404) 785-4683
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
73648
GA
Other
Enumeration date
07/02/2008
Last updated
06/06/2022
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