Individual
KELLY D DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
677 CHURCH ST NE # 111, MARIETTA, GA 30060
(770) 793-7750
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2007-01047
NC
207R00000X
Internal Medicine Physician
62332
GA
208M00000X
Hospitalist Physician
Primary
062332
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007-01047
NC MEDICAL LICENSE
NC
Enumeration date
07/02/2007
Last updated
10/16/2019
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