| Kiesha Marie Bullough, PA-C | |
|
700 Oakmound Rd, Clarksburg, WV 26301-9398 | |
| (304) 623-6330 | |
| (304) 623-6220 |
| Full Name | Kiesha Marie Bullough |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 15 Years |
| Location | 700 Oakmound Rd, Clarksburg, West Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700113412 | NPI | - | NPPES |
| 3810016314 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 01444 (West Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Virginia University Hospitals | Morgantown, WV | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| West Virginia University Medical Corporation | 1052224565 | 1621 |
| Mailing Address | Practice Location Address |
|---|---|
| Kiesha Marie Bullough, PA-C 700 Oakmound Rd, Clarksburg, WV 26301-9398 Ph: (304) 623-6330 | Kiesha Marie Bullough, PA-C 700 Oakmound Rd, Clarksburg, WV 26301-9398 Ph: (304) 623-6330 |
Janet L Childers, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4 Hospital Plz, Clarksburg, WV 26301 Phone: 304-624-1966 Fax: 304-293-6963 | |
Mr. James D Mcdaniel, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 469 Emily Dr, Clarksburg, WV 26301 Phone: 304-423-5180 Fax: 304-423-5185 | |
Mrs. Laura Jean Stavrakis, PAC Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 399 Emily Dr, Clarksburg, WV 26301 Phone: 304-624-4315 Fax: 304-624-4319 | |
Mabel Louise Wright, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1 Med Center Dr, Clarksburg, WV 26301 Phone: 304-623-3461 | |
Amy Marie Kerns, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 469 Emily Dr, Clarksburg, WV 26301 Phone: 304-423-5180 | |
Leigh Ana Bird, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 399 Emily Dr, Clarksburg, WV 26301 Phone: 304-624-4315 Fax: 304-624-4319 | |
Maureen E Lacaria, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 3 Hospital Plaza, United Hospital Center Er, Clarksburg, WV 26301 Phone: 304-624-1966 Fax: 304-293-6963 |