Individual
MRS. DANNETTE KALLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1701 BOULEVARD SQ STE D, WAYCROSS, GA 31501-8022
(912) 387-0445
(912) 226-3513
Mailing address
1701 BOULEVARD SQ STE D, WAYCROSS, GA 31501-8022
(912) 387-0445
(912) 226-3513
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
041044
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000758491E
—
GA
Enumeration date
10/23/2006
Last updated
09/13/2018
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