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General NPI Number Information
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NPI Number | 1285263111
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Entity Type | Individual
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Provider Name | MICHAEL PAUL KELLY M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 100 S MADISON ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-5473
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Country | US
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Telephone | 229-236-3816
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Fax |
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Provider Business Mailing Address
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Address Line | 1898 MERCHANTS ROW BLVD UNIT 35
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City | TALLAHASSEE
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State | FL
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Zip | 32311-4732
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Country | US
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Telephone | 614-914-9037
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME166180
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME166180
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 98838
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 98838
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME166180
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 98838
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License Number State | GA
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