Individual
BOBBY CHAD KELLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
2061 EXPERIMENT STATION RD # 505, WATKINSVILLE, GA 30677
(706) 310-0324
Mailing address
1230 BAXTER ST, ATHENS, GA 30606-3712
(404) 392-3548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7603
GA
363AM0700X
Medical Physician Assistant
2019
TN
Other
Enumeration date
09/26/2011
Last updated
08/08/2018
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