Individual
ROBERT O KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3931 MUNDY MILL RD., OAKWOOD, GA 30566
(770) 503-1481
(770) 503-1520
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34384
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034384
MED LIC NUMBER
GA
01
—
11D0898435
CLIA
GA
Enumeration date
02/21/2006
Last updated
03/07/2023
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