Individual
KEVIN T. CLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 HOSPITAL RD, NEWNAN, GA 30263-1210
(800) 532-6151
(770) 251-7873
Mailing address
PO BOX 5661, ATHENS, GA 30604-5661
(706) 354-5770
(706) 354-5769
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
052263
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
651957808E
—
GA
Enumeration date
10/11/2005
Last updated
07/08/2007
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