Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Douglas

Individual provider Physician Assistant · NPI 1912649120

Kelly Douglas is a Physician Assistant in Huntingdon, Tennessee. Qualified in 2022, 4 years ago. Practices with Evans Medical Clinic, PLLC, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
4
Licensed in
TN
In the registry since
2022

Practice location Address checks out

3493 Veterans Dr N Ste C
Huntingdon, TN 38344-6230
Phone: (731) 986-2933
Fax: (731) 986-2938
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 631 Rb Wilson Dr, Huntingdon, TN 38344-1727 — (731) 986-7021

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5629 (TN)

Record details

NPI number1912649120
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 8, 2022
Last updated in NPPESJuly 16, 2026
Certification dateJuly 16, 2026
Mailing address350 N Humphreys Blvd, Memphis, TN 38120-2177

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Evans Medical Clinic, Pllc — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Huntingdon