Individual
DR. KELLY TERRELL WILBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1428 DUNWOODY VILLAGE PKWY., DUNWOODY, GA 30338
(770) 394-2358
(770) 394-3055
Mailing address
1428 DUNWOODY VILLAGE PKWY., DUNWOODY, GA 30338
(770) 394-2358
(770) 394-3055
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
054698
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
899642472B
—
GA
Enumeration date
06/26/2006
Last updated
08/22/2011
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