Kendall Clevenger, PA is a
Physician Assistant based in Pine City, Minnesota. Kendall Clevenger is licensed to practice in Minnesota (license number 9635) and his current practice location is
510 2nd St Se, Pine City, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(320) 629-6721.
NPI number for Kendall Clevenger is 1154654218 and his current mailing address is 13709 Bistram Rd, Grantsburg, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1154654218.
Provider's Profile
| Full Name | Kendall Clevenger |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 510 2nd St Se, Pine City, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154654218
- Provider Enumeration Date: 09/08/2009
- Last Update Date: 09/08/2009
Medical Identifiers
Medical identifiers for Kendall Clevenger such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154654218 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 9635 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kendall Clevenger is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kendall Clevenger, PA
13709 Bistram Rd,
Grantsburg, WI 54840-7237
Ph: (715) 463-3816 | Kendall Clevenger, PA
510 2nd St Se,
Pine City, MN 55063-1706
Ph: (320) 629-6721 |
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