| Kristy Kate Shutts, MD | |
|
4851 Ky Route 321, Prestonsburg, KY 41653-9113 | |
| (606) 886-1173 | |
| (606) 886-2193 |
| Full Name | Kristy Kate Shutts |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 4851 Ky Route 321, Prestonsburg, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407933187 | NPI | - | NPPES |
| 64126451 | Medicaid | KY | |
| 7100004160 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 39531 (Kentucky) | Primary |
| Entity Name | Eastern Kentucky Tender Care Pediatrics, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043437254 PECOS PAC ID: 9537264262 Enrollment ID: O20110311000572 |
| Entity Name | Frontier Medical Associates Of Prestonsburg Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447840798 PECOS PAC ID: 8123436219 Enrollment ID: O20210408001619 |
| Mailing Address | Practice Location Address |
|---|---|
| Kristy Kate Shutts, MD Po Box 697, Prestonsburg, KY 41653-0697 Ph: (606) 886-1173 | Kristy Kate Shutts, MD 4851 Ky Route 321, Prestonsburg, KY 41653-9113 Ph: (606) 886-1173 |
Tiffany M Mills, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1709 Ky Route 321, Suite 3, Prestonsburg, KY 41653 Phone: 606-886-8546 Fax: 606-886-8548 | |
Dr. Antoin Hana, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 4851 Ky Route 321, Prestonsburg, KY 41653 Phone: 606-886-1173 Fax: 606-886-2193 | |
Mr. Mazen Jaafar, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5000 Ky Route 321 Ste 3124, Prestonsburg, KY 41653 Phone: 606-886-7635 Fax: 606-886-7680 | |
Dr. Rakesh Sachdeva, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 104 S Front Ave, Prestonsburg, KY 41653 Phone: 606-886-8572 Fax: 606-886-4433 |