Individual
KELVIN D. WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 DEVANT ST, SUITE 902, FAYETTEVILLE, GA 30214-2710
(770) 716-8228
(770) 716-6588
Mailing address
101 DEVANT ST, SUITE 902, FAYETTEVILLE, GA 30214-2710
(770) 716-8228
(770) 716-6588
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33753
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000445156F
—
GA
Enumeration date
12/07/2005
Last updated
07/16/2012
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