| Kelan Lane Osborn, | |
|
54 Hospital Dr Ste 102, Osage Beach, MO 65065-3050 | |
| (573) 348-8000 | |
| Not Available |
| Full Name | Kelan Lane Osborn |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 54 Hospital Dr Ste 102, Osage Beach, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851797971 | NPI | - | NPPES |
| 220112004 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA2441 (Oklahoma) | Secondary |
| 363A00000X | Physician Assistant | 2021038522 (Missouri) | Primary |
| Entity Name | Mercy Clinic Oklahoma Communities |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386874550 PECOS PAC ID: 1153468921 Enrollment ID: O20091027000755 |
| Entity Name | Mercy Hospital Tishomingo Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1972809002 PECOS PAC ID: 1557542032 Enrollment ID: O20180507002045 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelan Lane Osborn, 54 Hospital Dr, Osage Beach, MO 65065-3050 Ph: (573) 348-8000 | Kelan Lane Osborn, 54 Hospital Dr Ste 102, Osage Beach, MO 65065-3050 Ph: (573) 348-8000 |
Jacob Andrew White, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 660-888-2238 |
Ryan Willard Rogers, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1029 Nichols Rd Ste 201, Osage Beach, MO 65065 Phone: 573-302-7138 |
Michelle Therese Keeton, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-302-3999 Fax: 573-302-2751 |
Camden Schmitz, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1075 Nichols Rd, Osage Beach, MO 65065 Phone: 573-302-3990 |
Brandi Rene Nickels, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-348-8000 |
Trevor James Schuneman Sr., PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 54 Hospital Dr, Osage Beach, MO 65065 Phone: 573-302-2800 Fax: 573-348-8350 |
Tara Nicole Andersen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 54 Hospital Dr Ste 201, Osage Beach, MO 65065 Phone: 573-302-2764 Fax: 573-302-2767 |