| Mr Cullen Anthony Mack, PA-C | |
|
870 S Front St Ste 200, Central Point, OR 97502-2779 | |
| (541) 732-8120 | |
| Not Available |
| Full Name | Mr Cullen Anthony Mack |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 10 Years |
| Location | 870 S Front St Ste 200, Central Point, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104369099 | NPI | - | NPPES |
| 500723840 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA180563 (Oregon) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Providence Medford Medical Center | Medford, OR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Providence Health And Services Oregon | 5294623245 | 166 |
| Entity Name | Providence Health & Services Oregon |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568547503 PECOS PAC ID: 5294623245 Enrollment ID: O20040310000315 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Cullen Anthony Mack, PA-C Po Box 31001, Pasadena, CA 91110-4180 Ph: (541) 732-8120 | Mr Cullen Anthony Mack, PA-C 870 S Front St Ste 200, Central Point, OR 97502-2779 Ph: (541) 732-8120 |
Amy N Oppen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 870 S Front St Ste 20, Central Point, OR 97502 Phone: 541-664-3346 |
Craig Mason Kambich, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 870 S Front St Ste 200, Central Point, OR 97502 Phone: 541-732-8000 |
Sage G Sherer, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 870 S Front St Ste 200, Central Point, OR 97502 Phone: 541-732-8000 |
Daniel Stein, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4940 Hamrick Rd, Central Point, OR 97502 Phone: 541-535-6239 |
Tatyana M Wright, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 870 S Front St, Suite 200, Central Point, OR 97502 Phone: 541-664-3346 |
Mrs. Elizabeth Ann Rugg, PA, NP Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4940 Hamrick Rd, Central Point, OR 97502 Phone: 541-690-3600 Fax: 541-664-3735 |
Claudemir Da Silva Lima, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 870 S Front St Ste 200, Central Point, OR 97502 Phone: 541-732-8000 |