| Kelly E Fordham, PA-C | |
|
2900 Cahaba Rd, Mountain Brk, AL 35223-1937 | |
| (205) 877-9773 | |
| (205) 877-9775 |
| Full Name | Kelly E Fordham |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 13 Years |
| Location | 2900 Cahaba Rd, Mountain Brk, Alabama |
| 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 |
|---|---|---|---|
| 1578983433 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA.961 (Alabama) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Forefront Dermatology Sc | 3779471701 | 650 |
| Entity Name | Southeastern Dermatology Group PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518972231 PECOS PAC ID: 9931277233 Enrollment ID: O20110628000133 |
| Entity Name | Forefront Dermatology SC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366936759 PECOS PAC ID: 3779471701 Enrollment ID: O20180911002840 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly E Fordham, PA-C 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | Kelly E Fordham, PA-C 2900 Cahaba Rd, Mountain Brk, AL 35223-1937 Ph: (205) 877-9773 |
Louisa Eleanor Patrick, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2924 Southwood Rd, Mountain Brk, AL 35223 Phone: 205-937-3531 |
Amanda Rucker Lanier, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2900 Cahaba Rd, Mountain Brk, AL 35223 Phone: 205-877-9773 Fax: 205-877-9775 |
Emily Grace Apel, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 3939 Montclair Rd, Mountain Brk, AL 35213 Phone: 256-735-3549 |
Eulalie Draper Given Welden, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2900 Cahaba Rd, Mountain Brk, AL 35223 Phone: 205-877-9773 Fax: 205-877-9775 |
Michael Zicarelli, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4 Norman Dr, Mountain Brk, AL 35213 Phone: 205-515-5657 |
Dymond Callen, Physician Assistant Medicare: Medicare Enrolled Practice Location: 4 Office Park Cir Ste 306, Mountain Brk, AL 35223 Phone: 205-434-1424 |
Miss Leah Margaret Guarisco, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3000 Cahaba Village Plz, Mountain Brk, AL 35243 Phone: 205-263-7836 |