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NPI Code Detail

MEDICARE: MRS. PATRICIA ESTRELLA KELLY MD

MEDICARE: MRS. PATRICIA ESTRELLA KELLY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician048528GA

General Provider Information

NPI Number : 1801968755
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA ESTRELLA KELLY MD
Provider Business Mailing Address
First Line : 424 DECATUR ST SE
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1848
Country : US
Telephone Number : 678-843-8534
Fax Number : 678-843-8501
Provider Business Practice Location Address
First Line : 424 DECATUR ST SE
Second Line :
City : ATLANTA
State : GA
Zip : 30312-1848
Country : US
Telephone Number : 678-843-8534
Fax Number : 678-843-8501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2006
Last Update Date : 11/10/2011

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Directions to “ MRS. PATRICIA ESTRELLA KELLY MD” Practice Location

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