Individual
GORDON M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
355 CLEAR CREEK PKWY, SUITE 1003, LAVONIA, GA 30553-4174
(706) 356-4392
(866) 787-6602
Mailing address
58 BIG A RD, SUITE 1003, TOCCOA, GA 30577-6017
(706) 886-5624
(706) 827-5096
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101257941
VA
208600000X
Surgery Physician
Primary
33373
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000429019C
—
GA
05
—
1154314250
—
VA
Enumeration date
08/24/2005
Last updated
06/16/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us