| Grace P Kelly Md | |
|
5000 Highway 39 N Meridian MS 39301-1021 | |
| (601) 453-5393 | |
| (601) 581-9936 |
| Full Name | Grace P Kelly Md |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 5000 Highway 39 N, Meridian, Mississippi |
| Authorized Official Name and Position | Grace Patricia Kelly (OWNER) |
| Authorized Official Contact | 6014535393 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace P Kelly Md 5000 Highway 39 N Meridian MS 39301-1021 Ph: (601) 453-5393 | Grace P Kelly Md 5000 Highway 39 N Meridian MS 39301-1021 Ph: (601) 453-5393 |
| NPI Number | 1598933616 |
|---|---|
| Provider Enumeration Date | 02/11/2008 |
| Last Update Date | 06/19/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598933616 | NPI | - | NPPES |
| 072503544E | Other | MS | BLUE CROSS |
| 0001284 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | MS11556 (Mississippi) | Primary |
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