Davillier, Kelly R
Davillier, Kelly R is an individual health care provider with primary practice located at 55 Hiram Dr Building B, Hiram GA 30141-1844. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Davillier, Kelly R can be contacted via phone (678) 945-8300.Contact Information
Primary practice address
55 Hiram Dr Building B
Hiram GA 30141-1844
Phone: (678) 945-8300
Fax: (770) 445-2060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 060168 | Georgia |
Profile Details
| NPI number | 1164415998 |
|---|---|
| LBN Legal business name | Davillier, Kelly R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2005 |
| Last updated | Dec 21st, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164415998 | NPPES |
| Louisiana | MEDICAID | 1420565 | |
| Louisiana | MEDICAID | 1899964650A |
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