KELLEY P DOUGLAS MD
NPI 1184617474
Radiology - Diagnostic Radiology in Tifton, GA

Active since August 23, 2005
901 18TH ST E, TIFTON, GA 31794(912) 287-1515(912) 287-1394 Get Directions Write a Review

NPPES record last updated: November 17, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelley P Douglas Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLEY P DOUGLAS MD (NPI 1184617474) is an individual diagnostic radiology provider in Tifton, Georgia, licensed in Georgia (033957) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1184617474
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameKELLEY P DOUGLASCredential: MD
Location Address901 18TH ST ETifton, GA 31794-3648
Mailing Address901 18th St ETifton, GA 31794-3648 · (912) 287-1515 · Fax (912) 287-1394
Fax(912) 287-1394
Sole ProprietorNo
Enumeration DateAugust 23, 2005
Last NPPES UpdateNovember 17, 2007
NPI 1184617474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
License Licensed in GA · 033957
Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

901 18TH ST E, Tifton, GA 31794

Other Identifiers 2

Medicare UPINE81658
Medicare PIN30BDCGQGA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Nurse Practitioner (Acute Care)
901 18TH ST E
TIFTON, GA 31794
Student in an Organized Health Care Education/Training Program
901 18TH ST E
TIFTON, GA 31794
Internal Medicine (Pulmonary Disease)
901 18TH ST E
TIFTON, GA 31794
Physical Therapist
901 18TH ST E
TIFTON, GA 31794
Internal Medicine
901 18TH ST E
TIFTON, GA 31794
Nurse Anesthetist, Certified Registered
901 18TH ST E
TIFTON, GA 31794
Nurse Practitioner (Family)
901 18TH ST E
TIFTON, GA 31794

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelley Douglas's NPI number?

The NPI number for Kelley Douglas is 1184617474. It was assigned to this individual provider in the NPPES registry on August 23, 2005.

Where is Kelley Douglas located?

Kelley Douglas practices at 901 18th St E, Tifton, GA 31794. The listed phone number is (912) 287-1515.

What is Kelley Douglas's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for Kelley Douglas was last updated on November 17, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.