Provider Demographics
NPI:1902076433
Name:MCKELLAR, MARGI A (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:MARGI
Middle Name:A
Last Name:MCKELLAR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MARJORIE
Other - Middle Name:A
Other - Last Name:BURKHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1365 CLIFTON ROAD NE
Mailing Address - Street 2:BUILDING C 2ND FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-5479
Mailing Address - Fax:404-778-5676
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:BUILDING C 2ND FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-1900
Practice Address - Fax:404-778-5676
Is Sole Proprietor?:No
Enumeration Date:2008-03-12
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005273363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical