Organization
GRACE P KELLY MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE PATRICIA KELLY MD (OWNER)
(601) 453-5393
Entity
Organization
Contact information
Practice address
5003 POPLAR SPRINGS DR, MERIDIAN, MS 39305-1625
(601) 453-5393
(888) 735-7202
Mailing address
5000 HIGHWAY 39 N, MERIDIAN, MS 39301-1021
(601) 453-5393
(601) 581-9936
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
MS11556
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001284
—
MS
01
—
072503544E
BLUE CROSS
MS
Enumeration date
02/11/2008
Last updated
02/17/2025
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