| Kelly Bultman, | |
|
2510 Commons Blvd Ste 210, Beavercreek, OH 45431-3821 | |
| (513) 833-4912 | |
| Not Available |
| Full Name | Kelly Bultman |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2510 Commons Blvd Ste 210, Beavercreek, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104491414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 50.006573RX (Ohio) | Primary |
| Entity Name | Qualified Emergency Specialists Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700872728 PECOS PAC ID: 6002720430 Enrollment ID: O20031118001049 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Bultman, 2510 Commons Blvd Ste 210, Beavercreek, OH 45431-3821 Ph: (513) 833-4912 | Kelly Bultman, 2510 Commons Blvd Ste 210, Beavercreek, OH 45431-3821 Ph: (513) 833-4912 |
Amanda Yun Anania, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3535 Pentagon Blvd Ste 330, Beavercreek, OH 45431 Phone: 937-757-9449 Fax: 937-702-4944 |
Emily Grace Trompak (o'neal), PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3535 Pentagon Blvd, Beavercreek, OH 45431 Phone: 937-702-4450 Fax: 937-702-4459 |
Sarah Gould, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2510 Commons Blvd Ste 210, Beavercreek, OH 45431 Phone: 937-429-0607 Fax: 937-429-0608 |
Caitlin Riley Flynn, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3572 Dayton Xenia Rd Ste 105, Beavercreek, OH 45432 Phone: 937-427-4600 |
Breanne Henderson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 42 Woodcroft Trl, Beavercreek, OH 45430 Phone: 937-429-0682 |
Michelle A Ortman, P.A.-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 75 Sylvania Dr, Beavercreek, OH 45440 Phone: 937-320-5050 Fax: 937-320-5060 |
Mrs. Jennifer W Gonzalez, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 725 University Blvd, Beavercreek, OH 45324 Phone: 937-245-7200 Fax: 937-245-7999 |