Provider Demographics
NPI:1982929089
Name:COFFMAN, KELLY LYNN (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:LYNN
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:981 CANTON ST
Mailing Address - Street 2:STE 101
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-4240
Mailing Address - Country:US
Mailing Address - Phone:770-393-1880
Mailing Address - Fax:770-393-1885
Practice Address - Street 1:7000 PEACHTREE DUNWOODY RD STE 100
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-393-1880
Practice Address - Fax:770-393-1885
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2022-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA703762084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry