| Keelie Johnston, PA-C | |
|
1038 S Fleishel Ave, Tyler, TX 75701-2044 | |
| (903) 593-9474 | |
| (903) 593-9477 |
| Full Name | Keelie Johnston |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 5 Years |
| Location | 1038 S Fleishel Ave, Tyler, Texas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386344471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA16494 (Texas) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Epiphany Dermatology Pa | 3971827791 | 106 |
| Entity Name | Epiphany Dermatology PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043615263 PECOS PAC ID: 3971827791 Enrollment ID: O20150126001498 |
| Mailing Address | Practice Location Address |
|---|---|
| Keelie Johnston, PA-C 7300 Ranch Road 2222 Ste 200, Austin, TX 78730-3204 Ph: (512) 628-0465 | Keelie Johnston, PA-C 1038 S Fleishel Ave, Tyler, TX 75701-2044 Ph: (903) 593-9474 |
David Robert Dewalch, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 Olympic Plaza Cir Ste 600, Tyler, TX 75701 Phone: 903-596-3488 |
Anna Beth Willits, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3414 Golden Rd Apt B, Tyler, TX 75701 Phone: 325-665-8276 |
Mrs. Dawn Elise O'neal, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 Olympic Plaza Cir Ste 410, Tyler, TX 75701 Phone: 903-531-8950 |
Charles Crowell Pierce, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 619 S Fleishel Ave Ste 305, Tyler, TX 75701 Phone: 903-606-1173 |
Matthew Tassinari, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2208 Three Lakes Pkwy Ste 200, Tyler, TX 75703 Phone: 903-596-3844 Fax: 903-596-3843 |
Jordan Fayth Cooke, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 8101 S Broadway Ave, Tyler, TX 75703 Phone: 903-939-7500 Fax: 903-939-7728 |
Mrs. Megan Renee Followwell, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 5777 New Copeland Rd, Tyler, TX 75703 Phone: 903-561-9255 |