Provider Demographics
NPI:1285194506
Name:CAGE, KELSEY (MD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:CAGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 JESSE HILL JR. DRIVE SW
Mailing Address - Street 2:GLENN MEMORIAL BUILDING, 3RD FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-251-8915
Mailing Address - Fax:404-523-3931
Practice Address - Street 1:69 JESSE HILL JR DR SW
Practice Address - Street 2:GLENN MEMORIAL BUILDING, 3RD FLOOR
Practice Address - City:ALTANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-251-8915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA99568208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program