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Contact Information

KELLY S PHILLIPS, PA-C
1505 NORTHSIDE FORSYTH BLVD
STE 3500
CUMMING, GA30041
 Phone: 770-292-6500
 Fax: 770-292-6535
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for KELLY S PHILLIPS · (Female)

NPI Number 1194915496
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/01/2007
Last updated 06/02/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 007088
  • NC License # 0010-03244
  • TN License # 1512
  • TN License # PA0000001512
  • GA Medicaid 003144287E
  • GA Medicaid 003144287F
  • GA Medicaid 003144287H
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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