Individual
DR. PETER KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 543-3449
(706) 543-5744
Mailing address
PO BOX 7337, ATHENS, GA 30604-7337
(706) 543-3449
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
037847
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000719606B
—
GA
Enumeration date
05/25/2006
Last updated
05/07/2010
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