| Kellie Lea Mumford, PA-C | |
|
2147 Professional Dr, Gaylord, MI 49735-0003 | |
| (989) 732-1753 | |
| (989) 731-1425 |
| Full Name | Kellie Lea Mumford |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 16 Years |
| Location | 2147 Professional Dr, Gaylord, Michigan |
| 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 |
|---|---|---|---|
| 1346496759 | NPI | - | NPPES |
| OF96004 | Other | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5601005363 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Munson Healthcare Otsego Memorial Hospital | Gaylord, MI | Hospital |
| Charlevoix Area Hospital | Charlevoix, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bay Street Orthopaedics Pllc | 4688864788 | 21 |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Lea Mumford, PA-C 829 N Center Ave, Suite 298, Gaylord, MI 49735-1595 Ph: (989) 731-7708 | Kellie Lea Mumford, PA-C 2147 Professional Dr, Gaylord, MI 49735-0003 Ph: (989) 732-1753 |
Mr. Dominic Jerome Giallombardo, MT(ASCP), RN, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 652 N Otsego Ave, Gaylord, MI 49735 Phone: 989-732-3529 Fax: 989-732-7865 | |
Evan Steven Gravedoni, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1320 M-32, Gaylord, MI 49735 Phone: 989-731-5092 Fax: 989-705-8323 | |
Brittanie Hamlin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 829 N Center Ave, Gaylord, MI 49735 Phone: 989-731-7708 Fax: 989-731-7929 | |
Christopher David Blanchet, Physician Assistant Medicare: Medicare Enrolled Practice Location: 994 N Center Ave, Gaylord, MI 49735 Phone: 989-732-7843 Fax: 989-731-4513 | |
John Matthew Lawrence, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 829 N Center Ave, Suite 210, Gaylord, MI 49735 Phone: 989-731-7860 Fax: 989-731-7833 | |
Adam Derek-alan Moffatt, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1951 S Otsego Ave, Gaylord, MI 49735 Phone: 989-732-3284 Fax: 989-732-6395 |