Individual
KELLY MACPHAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11459 JOHNS CREEK PKWY STE 250, JOHNS CREEK, GA 30097-3517
(770) 497-1555
(770) 497-9998
Mailing address
11459 JOHNS CREEK PKWY STE 250, JOHNS CREEK, GA 30097-3517
(770) 497-1555
(770) 497-9998
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7846
GA
Other
Enumeration date
12/08/2015
Last updated
07/08/2021
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