Gordon M Kelly, MD is a
Surgery physician based in Lavonia, Georgia. Gordon M Kelly is licensed to practice in Georgia (license number 33373) and his current practice location is 355 Clear Creek Pkwy, Suite 1003, Lavonia, Georgia. He can be reached at his office (for appointments etc.) via phone at
(706) 356-4392.
NPI number for Gordon M Kelly is 1154314250 and his current mailing address is 58 Big A Rd, Suite 1003, Toccoa, Georgia. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1154314250.
Physician's Profile
| Full Name | Gordon M Kelly |
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| Gender | Male |
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| Speciality | Surgery |
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| Location | 355 Clear Creek Pkwy, Lavonia, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154314250
- Provider Enumeration Date: 08/24/2005
- Last Update Date: 06/16/2016
Medical Identifiers
Medical identifiers for Gordon M Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154314250 | NPI | - | NPPES |
| 000429019C | Medicaid | GA | |
| 1154314250 | Medicaid | VA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | 33373 (Georgia) | Primary |
| 208600000X | Surgery | 0101257941 (Virginia) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gordon M Kelly is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Gordon M Kelly, MD
58 Big A Rd, Suite 1003,
Toccoa, GA 30577-6017
Ph: (706) 886-5624 | Gordon M Kelly, MD
355 Clear Creek Pkwy, Suite 1003,
Lavonia, GA 30553-4174
Ph: (706) 356-4392 |
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