Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 025144 | GA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25144 | GA |
NPI | 1821051814 |
---|---|
Provider Name | Kelley B Dopson |
First Address | Atlanta, GA 30342-1626 |
Second Address | Atlanta, GA 30342-1626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 29/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00618626A | (05) | GA |
16BDFCX127575 | MEDICARE # (01) | GA |
D29324 | UPIN # (01) | GA |