Individual
JOHN W KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
191 DEEP SOUTH FARM RD, BLAIRSVILLE, GA 30512-2220
(706) 439-6380
(706) 439-6398
Mailing address
191 DEEP SOUTH FARM RD, BLAIRSVILLE, GA 30512-2220
(706) 439-6380
(706) 439-6398
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
16253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000187635IJK
—
GA
Enumeration date
06/05/2006
Last updated
10/20/2011
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