Brian E Kelly, MD | |
1202 5th Grant Blvd, Wabasha, MN 55981-1042 | |
(651) 565-4571 | |
Not Available |
Full Name | Brian E Kelly |
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Gender | Male |
Speciality | Family Medicine |
Location | 1202 5th Grant Blvd, Wabasha, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659341212 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 41302 (Minnesota) | Primary |
Entity Name | Mayo Clinic Health System-lake City |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164463659 PECOS PAC ID: 1951213487 Enrollment ID: O20060705000003 |
Mailing Address | Practice Location Address |
---|---|
Brian E Kelly, MD 1202 5th Grant Blvd, Wabasha, MN 55981-1042 Ph: (651) 565-4571 | Brian E Kelly, MD 1202 5th Grant Blvd, Wabasha, MN 55981-1042 Ph: (651) 565-4571 |
Fred Mcrae Roberson, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1202 5th Grant Blvd, Lake City Medical Center, Wabasha, MN 55981 Phone: 651-565-4571 Fax: 651-565-4818 | |
Ruth J. Tiffault, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1202 5th Grant Blvd, Wabasha, MN 55981 Phone: 651-565-4571 | |
Joseph V Mcgrath, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1202 5th Grant Blvd, Wabasha, MN 55981 Phone: 651-565-4571 | |
Garrett W Shanks, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1200 Grant Blvd W, Wabasha, MN 55981 Phone: 651-565-4531 | |
Earle C Munns, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 808 12th St E, Wabasha, MN 55981 Phone: 817-455-6927 | |
Kent Shepard Jeffery, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1018 Broadway Ave, Wabasha, MN 55981 Phone: 507-696-0248 |