Individual
KELLEY W CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(713) 500-3500
Mailing address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
78264
GA
207Q00000X
Family Medicine Physician
M1040
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173642301
—
TX
01
—
8S6142
BCBS
TX
Enumeration date
07/03/2006
Last updated
04/15/2026
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