Joseph Michael Mulligan, CRNA | |
515 Lake Front Rd., Leitchfield, KY 42754 | |
(270) 230-0377 | |
Not Available |
Full Name | Joseph Michael Mulligan |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 515 Lake Front Rd., Leitchfield, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689611469 | NPI | - | NPPES |
360955 | Other | IN | IN BCBS ANTHEM PROVIDER # |
10001010 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 28092549A (Indiana) | Primary |
Entity Name | Apollo Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1396179461 PECOS PAC ID: 3072741370 Enrollment ID: O20140113001443 |
Mailing Address | Practice Location Address |
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Joseph Michael Mulligan, CRNA 515 Lake Front Rd., Leitchfield, KY 42754 Ph: (270) 230-0377 | Joseph Michael Mulligan, CRNA 515 Lake Front Rd., Leitchfield, KY 42754 Ph: (270) 230-0377 |
John Anthony Lyons, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 904 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-9470 | |
Rodney D Mann, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 910 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-9512 | |
Jared Crocker, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 910 Wallace Ave, Leitchfield, KY 42754 Phone: 270-274-0480 | |
Mrs. Merry Lynn Green, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 904 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-9470 Fax: 270-259-1662 | |
Callie J Hancock, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 910 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-9512 | |
Mrs. Richelle Lynn Humphrey, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 904 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-9470 | |
Susan Kirkwood, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 317 N English St, Leitchfield, KY 42754 Phone: 502-550-4164 |