| Jaclyn L Mascarin, PA | |
|
1221 Pine Grove Ave, Port Huron, MI 48060-3511 | |
| (810) 989-3300 | |
| Not Available |
| Full Name | Jaclyn L Mascarin |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 1221 Pine Grove Ave, Port Huron, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639512791 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA9107043 (Florida) | Secondary |
| 363A00000X | Physician Assistant | 5601011637 (Michigan) | Primary |
| Entity Name | Bay Area Emergency Physicians LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164459095 PECOS PAC ID: 2668368952 Enrollment ID: O20040224000862 |
| Entity Name | Coastline Emergency Physicians LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891744769 PECOS PAC ID: 2466633821 Enrollment ID: O20110218000441 |
| Mailing Address | Practice Location Address |
|---|---|
| Jaclyn L Mascarin, PA Po Box 595498, Fort Gratiot, MI 48059-5498 Ph: (810) 300-4887 | Jaclyn L Mascarin, PA 1221 Pine Grove Ave, Port Huron, MI 48060-3511 Ph: (810) 989-3300 |
Ms. Salwa Wadud Choudhury, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1201 Stone St, Suite #3, Port Huron, MI 48060 Phone: 810-985-5000 Fax: 810-985-3700 |
Jacklyn Burkey, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1209 10th St, Port Huron, MI 48060 Phone: 810-985-8170 |
Shaun Baker, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2425 Military St Rm 2, Port Huron, MI 48060 Phone: 810-984-5700 Fax: 810-984-1886 |
Ashley Lauren Wilson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 940 River Centre Dr, Port Huron, MI 48060 Phone: 810-985-4900 Fax: 810-985-3634 |
Nicholas M Branch, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1231 Pine Grove Ave Ste 1a, Port Huron, MI 48060 Phone: 810-985-4300 Fax: 810-985-9320 |
Scott Michael Dedoe, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1221 Pine Grove Ave, Emergency Medicine Department, Port Huron, MI 48060 Phone: 810-989-3300 Fax: 810-985-2671 |
Riley Robinson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1221 Pine Grove Ave, Port Huron, MI 48060 Phone: 810-987-5000 Fax: 810-985-2671 |