Provider Demographics
NPI:1457485690
Name:VELIE, JODY S (MD)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:S
Last Name:VELIE
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 1:1025 KEITH DR
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:GA
Mailing Address - Zip Code:31069-2948
Mailing Address - Country:US
Mailing Address - Phone:478-988-1515
Mailing Address - Fax:478-988-1550
Practice Address - Street 1:1025 KEITH DR
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:GA
Practice Address - Zip Code:31069-2948
Practice Address - Country:US
Practice Address - Phone:478-988-1515
Practice Address - Fax:478-988-1550
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine