| Dr Kelly S Tate, MD | |
|
118 S Main St, Elkton, KY 42220-8863 | |
| (270) 265-5023 | |
| (270) 265-5026 |
| Full Name | Dr Kelly S Tate |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 39 Years |
| Location | 118 S Main St, Elkton, Kentucky |
| 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 |
|---|---|---|---|
| 1700839040 | NPI | - | NPPES |
| 64271489 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 27148 (Kentucky) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Lifeline Health Care Of Logan | Russellville, KY | Home health agency |
| Logan Memorial Hospital | Russellville, KY | Hospital |
| Jennie Stuart Medical Center | Hopkinsville, KY | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Commonwealth Health Corporation, Inc. | 5496667628 | 391 |
| Entity Name | Logan Physician Practice Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265740765 PECOS PAC ID: 4880596592 Enrollment ID: O20040219000212 |
| Entity Name | Commonwealth Health Corporation, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881109304 PECOS PAC ID: 5496667628 Enrollment ID: O20040916000800 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kelly S Tate, MD 118 S Main St, Elkton, KY 42220-8863 Ph: (270) 265-5023 | Dr Kelly S Tate, MD 118 S Main St, Elkton, KY 42220-8863 Ph: (270) 265-5023 |
Thomas G. Grabenstein, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 810 S Main St, Elkton, KY 42220 Phone: 270-265-5600 Fax: 270-265-5605 | |
Dr. Mallory C. Jorif, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 810 S Main St, Elkton, KY 42220 Phone: 270-265-5600 Fax: 270-265-5605 | |
Beth A Meade, APRN Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 105 Elk Fork Rd, Elkton, KY 42220 Phone: 270-265-2574 |