| Kell Medical Pa | |
|
200 Doctors Dr Ste F Jacksonville NC 28546-6308 | |
| (910) 353-1499 | |
| (910) 355-0404 |
| Full Name | Kell Medical Pa |
|---|---|
| Speciality | General Practice |
| Location | 200 Doctors Dr Ste F, Jacksonville, North Carolina |
| Authorized Official Name and Position | Robert E Kell (PRIMARY DOCTOR) |
| Authorized Official Contact | 9103531499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kell Medical Pa 200 Doctors Dr Ste F Jacksonville NC 28546-6308 Ph: (910) 353-1499 | Kell Medical Pa 200 Doctors Dr Ste F Jacksonville NC 28546-6308 Ph: (910) 353-1499 |
| NPI Number | 1508027046 |
|---|---|
| Provider Enumeration Date | 06/18/2008 |
| Last Update Date | 11/17/2022 |
| Medicare PECOS PAC ID | 5496813180 |
|---|---|
| Medicare Enrollment ID | O20081117000585 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508027046 | NPI | - | NPPES |
| 48308 | Other | NC | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | 9600132 (North Carolina) | Secondary |
| Provider Name | Robert E Kell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710086236 PECOS PAC ID: 0547363665 Enrollment ID: I20081028000733 |
| Provider Name | Victoria Lynn Kell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386856649 PECOS PAC ID: 2860550555 Enrollment ID: I20141213000113 |
| Provider Name | Jeri Allison Mccarson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1497738744 PECOS PAC ID: 6709143084 Enrollment ID: I20220902001816 |
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