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General NPI Number Information
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NPI Number | 1700439585
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Entity Type | Individual
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Provider Name | MARY KELLY HEDGPETH PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 275 PERRY PKWY
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City | PERRY
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State | GA
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Zip | 31069-9275
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Country | US
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Telephone | 478-218-7582
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Fax |
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Provider Business Mailing Address
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Address Line | 116A WASHINGTON PLACE DR
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City | PERRY
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State | GA
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Zip | 31069-4845
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Country | US
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Telephone | 478-925-6254
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH031488
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License Number State | GA
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