Individual
KELLY C GROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
340 N MILLEDGE AVE STE B, ATHENS, GA 30601-3806
(706) 548-0008
(706) 369-9673
Mailing address
1001 SUMMIT BLVD STE 200, BROOKHAVEN, GA 30319-6410
(770) 989-1668
(706) 369-9673
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
051353
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382474810H
—
GA
Enumeration date
06/23/2006
Last updated
10/03/2018
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