| Charles Kelly, DO | |
|
1 Medical Park Dr, Fulton, MS 38843-9001 | |
| (662) 862-5200 | |
| (662) 862-5297 |
| Full Name | Charles Kelly |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 32 Years |
| Location | 1 Medical Park Dr, Fulton, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104895267 | NPI | - | NPPES |
| 00117294 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15058 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| North Mississippi Medical Ctr Hha | Tupelo, MS | Home health agency |
| Kindred At Home | Tupelo, MS | Home health agency |
| North Mississippi Medical Ctr | Tupelo, MS | Hospice |
| North Mississippi Medical Center | Tupelo, MS | Hospital |
| North Mississippi Medical Center-gilmore Amory | Amory, MS | Hospital |
| Tishomingo Health Services Inc | Iuka, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Mississippi Medical Clinics Inc | 6103736665 | 116 |
| Entity Name | North Mississippi Medical Clinics Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053469486 PECOS PAC ID: 6103736665 Enrollment ID: O20040127000582 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Kelly, DO 1 Medical Park Dr, Fulton, MS 38843-9001 Ph: (662) 862-5200 | Charles Kelly, DO 1 Medical Park Dr, Fulton, MS 38843-9001 Ph: (662) 862-5200 |
Dr. Benton Ernest Kilman, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Park Dr, Fulton, MS 38843 Phone: 662-862-5200 Fax: 662-862-5297 | |
Dr. Michael George Howell, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 204 Wheeler Dr, Fulton, MS 38843 Phone: 662-862-2025 Fax: 662-862-2026 | |
Dr. Shelli I Coleman, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 302 Hospital Rd, Fulton, MS 38843 Phone: 662-862-7047 Fax: 662-862-7053 | |
Raymond Rudolph Arriola, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Park Dr, Fulton, MS 38843 Phone: 662-862-5200 Fax: 662-862-5297 | |
Grayden Tubb, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Park Dr, Fulton, MS 38843 Phone: 662-862-5200 Fax: 662-862-5297 | |
Kathryn Pastrell, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Park Dr, Fulton, MS 38843 Phone: 662-862-5200 Fax: 662-862-5297 |