GEORGIE KELLEY P.A. NPI 1073664793

NPI Information

Georgie Kelley, P.A. is a medical physician assistant in Tacoma, WA. Georgie Kelley, P.A. NPI is 1073664793. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

209 MARTIN LUTHER KING JR WAY
TACOMA, WA
ZIP 98405-265
Phone: (253) 383-6120

The NPI 1073664793 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 9/14/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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