Provider Demographics
NPI:1164694089
Name:CALLINS, KEISHA RENEE (MD, MPH)
Entity Type:Individual
Prefix:MRS
First Name:KEISHA
Middle Name:RENEE
Last Name:CALLINS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4292 GRAY HWY
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:GA
Mailing Address - Zip Code:31032-5900
Mailing Address - Country:US
Mailing Address - Phone:478-301-2362
Mailing Address - Fax:478-301-2272
Practice Address - Street 1:1550 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31207-1500
Practice Address - Country:US
Practice Address - Phone:478-301-2696
Practice Address - Fax:478-301-2116
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA879908207V00000X
GA065643207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology