Wilburn, Kelly Terrell
Wilburn, Kelly Terrell is an individual health care provider with primary practice located at 1428 Dunwoody Village Pkwy. , Dunwoody GA 30338. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wilburn, Kelly Terrell can be contacted via phone (770) 394-2358.Contact Information
Primary practice address
1428 Dunwoody Village Pkwy.
Dunwoody GA 30338
Phone: (770) 394-2358
Fax: (770) 394-3055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 054698 | Georgia |
Profile Details
| NPI number | 1104853373 |
|---|---|
| LBN Legal business name | Wilburn, Kelly Terrell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Aug 22nd, 2011 - about 13 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 | 1104853373 | NPPES |
| Georgia | MEDICAID | 899642472B |
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