Dr Kenneth W Kellough, MD | |
705 N State St, Clarksdale, MS 38614-6519 | |
(662) 621-2192 | |
(662) 621-2314 |
Full Name | Dr Kenneth W Kellough |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 705 N State St, Clarksdale, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609815000 | NPI | - | NPPES |
00121009 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 16776 (Mississippi) | Primary |
Entity Name | Acs Emergency Services Of Mississippi Professional Association |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396996997 PECOS PAC ID: 7719049998 Enrollment ID: O20081222000668 |
Entity Name | Mississippi Emergency Physician Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710220678 PECOS PAC ID: 2264672492 Enrollment ID: O20130710000827 |
Mailing Address | Practice Location Address |
---|---|
Dr Kenneth W Kellough, MD 705 N State St, Clarksdale, MS 38614-6519 Ph: (662) 621-2192 | Dr Kenneth W Kellough, MD 705 N State St, Clarksdale, MS 38614-6519 Ph: (662) 621-2192 |
April Danielle Carter, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1970 Hospital Dr, Clarksdale, MS 38614 Phone: 337-842-7896 | |
Gowdhami Mohan, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 785 Ohio Ave Ste 3e, Clarksdale, MS 38614 Phone: 662-351-0702 Fax: 662-351-0703 | |
Dr. Aman U Munir, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 785 Ohio Ave, Ste 2h, Clarksdale, MS 38614 Phone: 662-627-3003 Fax: 662-627-3095 | |
Dr. Nikki Nikkia Cager, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 785 Ohio Ave Ste 2d, Clarksdale, MS 38614 Phone: 662-627-2509 Fax: 662-627-2420 | |
Vikram Reddy Beemidi, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 785 Ohio Ave, Suite 2h, Clarksdale, MS 38614 Phone: 662-627-3003 Fax: 662-627-3014 | |
Dr. Richard E Brownstein, M.D. Internal Medicine Medicare: May Accept Medicare Assignments Practice Location: 785 Ohio Ave, Suite 3e, Clarksdale, MS 38614 Phone: 662-624-5801 Fax: 662-624-5804 |