Kelly, Carrie
Kelly, Carrie is an individual health care provider with primary practice located at 1020 Jamestown Blvd Bldg 200, Watkinsville GA 30677-4131. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Kelly, Carrie can be contacted via phone (706) 769-0005.Contact Information
Primary practice address
1020 Jamestown Blvd Bldg 200
Watkinsville GA 30677-4131
Phone: (706) 769-0005
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | TL28040 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 61103 | Georgia |
Profile Details
| NPI number | 1053339200 |
|---|---|
| LBN Legal business name | Kelly, Carrie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Jan 18th, 2016 - about 8 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 | 1053339200 | NPPES |
| Georgia | MEDICAID | 402113351B |
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