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Organization

KELVIN MOSS MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELVIN MOSS MD (OWNER)
(706) 636-6677
Entity
Organization

Contact information

Practice address
83 SOUTHSIDE CHURCH ST, ELLIJAY, GA 30540-5400
(706) 636-6677
Mailing address
83 SOUTHSIDE CHURCH ST, ELLIJAY, GA 30540-5400
(706) 636-6677

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GA 054634
GA

Other

Enumeration date
05/22/2008
Last updated
09/02/2008
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