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Organization

ATHENS GYNECOLOGY PC

Active
Other names
Eastside Gynecology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT EARL KELLEY JR. MD (PHYSICIAN PRESIDENT)
(706) 548-4424
Entity
Organization

Contact information

Practice address
1270 PRINCE AVENUE, SUITE 202, ATHENS, GA 30606
(706) 548-4424
(706) 548-4880
Mailing address
1580 TREE LN, PO BOX 325, SNELLVILLE, GA 30078-2207
(770) 978-7246
(770) 979-8348

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000084763B
GA
Enumeration date
06/18/2007
Last updated
04/24/2008
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