Individual
SALLY M MCKELLAR
Active
Individual
SALLY M MCKELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD19245
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000432198B
—
GA
05
—
009102580
—
AL
01
—
050013515
MEDICARE RAILROAD
TN
05
—
3038861
—
TN
01
—
3044404
BLUE CROSS BLUE SHIELD OF TN
TN
05
—
890692K
—
NC
01
—
N358416
WELLCARE ( GA MEDICAID)
GA
Enumeration date
11/16/2006
Last updated
01/14/2010
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