Kelley, Michael A
Kelley, Michael A is an individual health care provider with primary practice located at 3131 S Main St , Moultrie GA 31768-6925. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Kelley, Michael A can be contacted via phone (229) 502-9782.Contact Information
Primary practice address
3131 S Main St
Moultrie GA 31768-6925
Phone: (229) 502-9782
Fax: (229) 891-9567
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 050193 | Georgia |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 050193 | Georgia |
Profile Details
| NPI number | 1104984871 |
|---|---|
| LBN Legal business name | Kelley, Michael A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 5th, 2006 |
| Last updated | Jul 28th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104984871 | NPPES |
| Alabama | MEDICAID | 009933634 | |
| Alabama | Other | 051531688 |
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