Individual
KELSEY H. TATONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(706) 544-0188
Mailing address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(706) 544-0188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA.0005673
CO
363AM0700X
Medical Physician Assistant
Primary
017542
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01995615-GROUP
—
NY
Enumeration date
03/29/2013
Last updated
11/05/2024
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