Individual
DR. IRIS CHAMBLISS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
657 HEMLOCK ST, SUITE 220, MACON, GA 31201-8329
(478) 741-7241
(478) 745-8932
Mailing address
657 HEMLOCK ST, SUITE 220, MACON, GA 31201-8329
(478) 741-7241
(478) 745-8932
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
051488
GA
207R00000X
Internal Medicine Physician
23070
SC
208M00000X
Hospitalist Physician
51448
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230707
—
SC
01
—
5562814
CIGNA
SC
01
—
57-6007863071
BLUE CHOICE OF SC
SC
01
—
57-6007863095
BCBS OF SC
SC
01
—
7649442
AETNA
SC
Enumeration date
05/18/2006
Last updated
11/17/2015
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