Healthcare Provider Details

I. General information

NPI: 1417290388
Provider Name (Legal Business Name): KELSEY H. TATONE P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY M. HANKS

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 VAN AALST BLVD
FORT BENNING GA
31905-2102
US

IV. Provider business mailing address

6600 VAN AALST BLVD
FORT BENNING GA
31905-2102
US

V. Phone/Fax

Practice location:
  • Phone: 706-544-3133
  • Fax:
Mailing address:
  • Phone: 706-544-3133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number017542
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0005673
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: