| Kelly Douglas, | |
|
3493 Veterans Dr N Ste C, Huntingdon, TN 38344-6230 | |
| (731) 986-2933 | |
| (731) 986-2938 |
| Full Name | Kelly Douglas |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 3493 Veterans Dr N Ste C, Huntingdon, Tennessee |
| 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 |
|---|---|---|---|
| 1912649120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 5629 (Tennessee) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Volunteer Home Care | Humboldt, TN | Home health agency |
| Baptist Memorial Hospital - Carroll County | Huntingdon, TN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Evans Medical Clinic, Pllc | 3870772817 | 7 |
| Entity Name | Evans Medical Clinic, PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598083982 PECOS PAC ID: 3870772817 Enrollment ID: O20110124000757 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Douglas, 350 N Humphreys Blvd, Memphis, TN 38120-2177 Ph: (901) 226-4003 | Kelly Douglas, 3493 Veterans Dr N Ste C, Huntingdon, TN 38344-6230 Ph: (731) 986-2933 |
Mr. Paul Everett Brinkman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3493 Veterans Dr N Ste C, Huntingdon, TN 38344 Phone: 731-986-2933 Fax: 731-986-2938 |
Meagen Sturdivant Maddox, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3493 Veterans Dr N, Suite C, Huntingdon, TN 38344 Phone: 731-986-2933 Fax: 731-986-2938 |
Tyler S Warbritton, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3493 Veterans Dr N Ste C, Huntingdon, TN 38344 Phone: 731-986-2933 Fax: 731-986-2939 |
Gary Christopher Blount, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 641 Rb Wilson Dr Ste G, Huntingdon, TN 38344 Phone: 731-986-7400 |
Ashleigh Nichole Bullock, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 238 Hillcrest Dr, Huntingdon, TN 38344 Phone: 731-415-6313 |
Sarah Elizabeth Wiser, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 22 2nd Ave, Huntingdon, TN 38344 Phone: 731-422-0213 Fax: 731-868-4766 |
Clinton Jed Blaine, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3500 Purdy Rd, Huntingdon, TN 38344 Phone: 731-986-2536 |