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General NPI Number Information
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NPI Number | 1275488751
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Entity Type | Individual
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Provider Name | MCKINLEY KEMP PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/02/2026
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1035 SOUTHCREST DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6118
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Country | US
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Telephone | 770-389-9005
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 DOWNWOOD CIR NW
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City | ATLANTA
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State | GA
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Zip | 30327-1698
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Country | US
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Telephone | 770-389-9005
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 13722
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License Number State | GA
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