| Randy Kellenberger, DO | |
|
800 Ravenhill Dr, Emergency Department, Atchison, KS 66002-9204 | |
| (913) 360-5320 | |
| Not Available |
| Full Name | Randy Kellenberger |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 800 Ravenhill Dr, Atchison, Kansas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932186681 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | R9G92 (Missouri) | Primary |
| Entity Name | Salem Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114177557 PECOS PAC ID: 7012801129 Enrollment ID: O20040210000857 |
| Entity Name | Texas County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790740363 PECOS PAC ID: 9436041696 Enrollment ID: O20040401000307 |
| Entity Name | Salem Memorial Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1639177561 PECOS PAC ID: 7012801129 Enrollment ID: O20150211000221 |
| Mailing Address | Practice Location Address |
|---|---|
| Randy Kellenberger, DO 16410 Riggs Rd, Stilwell, KS 66085-9128 Ph: (913) 681-3217 | Randy Kellenberger, DO 800 Ravenhill Dr, Emergency Department, Atchison, KS 66002-9204 Ph: (913) 360-5320 |
Dr. Justin Lee Theleman, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 Ravenhill Dr, Atchison, KS 66002 Phone: 913-367-2131 Fax: 913-674-2040 |