Provider Demographics
NPI:1124438619
Name:MCFALL, KELSAY (DO)
Entity type:Individual
Prefix:DR
First Name:KELSAY
Middle Name:
Last Name:MCFALL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N HOUSTON RD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-2101
Mailing Address - Country:US
Mailing Address - Phone:478-922-4010
Mailing Address - Fax:478-225-2652
Practice Address - Street 1:707 N HOUSTON RD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-2101
Practice Address - Country:US
Practice Address - Phone:478-922-4010
Practice Address - Fax:478-225-2652
Is Sole Proprietor?:No
Enumeration Date:2014-05-06
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA83349207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine