Kelly E Graham (NPI# 1588093157, PAC ID# 5294961140) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1588093157 |
| PAC ID by PECOS | 5294961140 |
| Professional Enrollment ID | I20131122001788 |
| Full Name | Kelly E Graham |
| Organization Legal Name | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| Address |
1366 Wellbrook Cir Ne Suite B Conyers GA 30012-3872 |
| Phone Number | 4042529063 |
| Gender | F |
| Graduation Year | 2013 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 8628253424 |
| Number of Group Practice Members | 161 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342-1606 | 4048518000 | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| 1366 Wellbrook Cir Ne, Suite B, Conyers, GA 30012-3872 | 4042529063 | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| 1100 Northside Forsyth Dr, Cumming, GA 30041-6015 | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| Organization Legal Name | NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC |
| Physicians | 168 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jessica F Wysock | Nurse Practitioner | Northside Surgical Professional Services LLC | 1100 Northside Forsyth Dr, Suite 410, Cumming, GA 30041-6015 |
| Torrance Christopher Laury | Family Medicine | Northside Surgical Professional Services LLC | 2000 Howard Farm Dr, Suite 305, Cumming, GA 30041-6075 |
| Tayler Mauldin | Nurse Practitioner | Northside Surgical Professional Services LLC | 460 Northside Cherokee, Suite 410, Canton, GA 30115-8016 |
| Eddie K Abdalla | General Surgery | Northside Surgical Professional Services LLC | 980 Johnson Fy Rd Ne, Suite 170, Atlanta, GA 30342-1607 |
| Kelley Dawn Harrelson | Nurse Practitioner | Northside Surgical Professional Services LLC | 759 Old Norcross Rd, Lawrenceville, GA 30046-4317 |
| Soyini Mattis Hawkins | Obstetrics/gynecology | Northside Surgical Professional Services LLC | 11975 Morris Rd, Suite 140, Alpharetta, GA 30005-4444 |
| Grant C Wolfe | General Surgery | Northside Surgical Professional Services LLC | 900 Towne Lake Pkwy, Suite 412, Woodstock, GA 30189-1604 |
| Pauline Elizabeth Mallcott | Qualified Audiologist | Northside Surgical Professional Services LLC | 4150 Deputy Bill Cantrall Memorial Rd, Suite 260, Cumming, GA 30005 |
| Crystal R Dininger | Physician Assistant | Northside Surgical Professional Services LLC | 1366 Wellbrook Cir Ne, Suite B, Conyers, GA 30012-3872 |
| Rama K Rao | Obstetrics/gynecology | Northside Surgical Professional Services LLC | 2001 Peachtree Nerd, Suite 650, Atlanta, GA 30309-1432 |
| Street Address |
1366 WELLBROOK CIR NE SUITE B |
| City | CONYERS |
| State | GA |
| Zip | 30012-3872 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Crystal R Dininger | Physician Assistant | Northside Surgical Professional Services LLC | 1366 Wellbrook Cir Ne, Suite B, Conyers, GA 30012-3872 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Steven T Wilder | Chiropractic | 1091 W Ave Sw, Conyers, GA 30012 | |
| Sitharam Chowdary Nandigam | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Ekundayo A Falase | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Yilikal Tassew Kassa | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Nardos Ketema Belayneh | Nephrology | Eastside Premier Nephrology and Hypertension PC | 1612 Milstead Rd, Suite A, Conyers, GA 30012-3738 |
| Neil A Trossevin | Physician Assistant | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Allen A Futral | Urology | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Bert T Chen | Urology | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Froylan C Gonzales | Urology | Georgia Urology, Pa | 1301 Sigman Rd Ne, Suite 250a, Conyers, GA 30012-3812 |
| Kisha Adderley | Nurse Practitioner | Rockdale Physician Practices LLC | 1301 Sigman Rd Ne, Suite 125, Conyers, GA 30012-3812 |
| Find all physicians in zip 30012 | |||
| City | CONYERS |
| Zip Code | 30012 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | CONYERS + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Kelly E Graham.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.