| Dr Christopher Francis Fennell, DO | |
|
910 Kenton Station Dr, Maysville, KY 41056-9613 | |
| (606) 759-0490 | |
| (606) 759-0499 |
| Full Name | Dr Christopher Francis Fennell |
|---|---|
| Gender | Male |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 910 Kenton Station Dr, Maysville, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437133535 | NPI | - | NPPES |
| 7100210560 | Medicaid | KY | |
| 03372 | Other | KY | MEDICAL LICENSE |
| K041011 | Other | KY | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 34-007773 (Ohio) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 03372 (Kentucky) | Primary |
| Entity Name | St. Claire Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821168535 PECOS PAC ID: 4486559085 Enrollment ID: O20031205000579 |
| Entity Name | Lewis County Primary Care Center, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457303802 PECOS PAC ID: 1153311774 Enrollment ID: O20040515000278 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Christopher Francis Fennell, DO Po Box 3450, Regional Behavioral Health Center, Rapid City, SD 57709-3450 Ph: (605) 719-7200 | Dr Christopher Francis Fennell, DO 910 Kenton Station Dr, Maysville, KY 41056-9613 Ph: (606) 759-0490 |
Dr. George A Mercado, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 611 Forest Ave, Maysville, KY 41056 Phone: 606-564-4016 Fax: 606-564-8288 | |
Dr. L Jean Cooper, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 611 Forest Ave, Maysville, KY 41056 Phone: 606-564-4016 |