| Marshall Co Surgical & Medical Group | |
|
619 Old Symsonia Rd Benton KY 42025-5094 | |
| (270) 527-2411 | |
| (270) 527-8734 |
| Full Name | Marshall Co Surgical & Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 619 Old Symsonia Rd, Benton, Kentucky |
| Authorized Official Name and Position | Janice Kelley (CFO) |
| Authorized Official Contact | 2705274852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marshall Co Surgical & Medical Group 619 Old Symsonia Rd Benton KY 42025-5094 Ph: (270) 527-2411 | Marshall Co Surgical & Medical Group 619 Old Symsonia Rd Benton KY 42025-5094 Ph: (270) 527-2411 |
| NPI Number | 1689778250 |
|---|---|
| Provider Enumeration Date | 09/12/2006 |
| Last Update Date | 10/15/2015 |
| Medicare PECOS PAC ID | 3375581986 |
|---|---|
| Medicare Enrollment ID | O20050422000645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689778250 | NPI | - | NPPES |
| 01015338 | Medicaid | KY | |
| 000000054610 | Other | KY | BLUE CROSS |
| 78905304 | Medicaid | KY | |
| 000000057043 | Other | KY | BLUE CROSS AND BLUE SHIEL |
| 110104797 | Other | RR MEDICARE | |
| DF7240 | Other | KY | RR MEDICARE |
| 65912362 | Medicaid | KY |
| Provider Name | Bruce Steven David |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922190412 PECOS PAC ID: 1254221922 Enrollment ID: I20040317000330 |
| Provider Name | Diane E Kolenich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639121882 PECOS PAC ID: 1951392968 Enrollment ID: I20040602000083 |
| Provider Name | William T Powell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891707642 PECOS PAC ID: 5193709285 Enrollment ID: I20040616000487 |
| Provider Name | Robert Masse |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144367566 PECOS PAC ID: 9537134382 Enrollment ID: I20040826000729 |
| Provider Name | Robert W Beale |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992724645 PECOS PAC ID: 3779559786 Enrollment ID: I20040909000914 |
| Provider Name | Robert C Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265403265 PECOS PAC ID: 7012984511 Enrollment ID: I20040914000815 |
| Provider Name | Edwin Perez-lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447272299 PECOS PAC ID: 4587609417 Enrollment ID: I20050622000236 |
| Provider Name | Leonard J Hohlbein |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063563682 PECOS PAC ID: 8729004163 Enrollment ID: I20051014000850 |
| Provider Name | James M Hawkins |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346274438 PECOS PAC ID: 9133195647 Enrollment ID: I20070629000224 |
| Provider Name | Jaime L Rhodes |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1962582833 PECOS PAC ID: 5294834057 Enrollment ID: I20070706000315 |
| Provider Name | Richard S Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952508715 PECOS PAC ID: 0547340614 Enrollment ID: I20080102000007 |
| Provider Name | Rhonda K Darnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649420225 PECOS PAC ID: 4183781438 Enrollment ID: I20090401000020 |
| Provider Name | Julia T Lyles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740434307 PECOS PAC ID: 4981758356 Enrollment ID: I20090819000591 |
| Provider Name | Melissa A Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689979841 PECOS PAC ID: 7416130992 Enrollment ID: I20110321000724 |
| Provider Name | Ann Matejcek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174694871 PECOS PAC ID: 5597948752 Enrollment ID: I20110324000898 |
| Provider Name | Sanjay Bose |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225038698 PECOS PAC ID: 1355362617 Enrollment ID: I20110422000413 |
| Provider Name | Christina Michelle Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598057549 PECOS PAC ID: 3072785716 Enrollment ID: I20110930000555 |
| Provider Name | Ali J Jessee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396922118 PECOS PAC ID: 9830371459 Enrollment ID: I20120130000508 |
| Provider Name | Michael J Hicks |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417142449 PECOS PAC ID: 0446347587 Enrollment ID: I20120816000076 |
| Provider Name | Cara L Hammonds |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1841401494 PECOS PAC ID: 1557557634 Enrollment ID: I20131204001260 |
| Provider Name | Tonya Denise Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285034629 PECOS PAC ID: 0244452829 Enrollment ID: I20141114001835 |
| Provider Name | Sharon R Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366811796 PECOS PAC ID: 3971812199 Enrollment ID: I20151028002415 |
| Provider Name | Amanda Massey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124569553 PECOS PAC ID: 0648548404 Enrollment ID: I20170620000700 |
| Provider Name | Steven Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386166932 PECOS PAC ID: 4587936786 Enrollment ID: I20170823001986 |
| Provider Name | Reanna Christine Hargrove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982171484 PECOS PAC ID: 6406191774 Enrollment ID: I20181214002897 |
| Provider Name | Meredith A Crider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447713623 PECOS PAC ID: 8527391671 Enrollment ID: I20190605001907 |
| Provider Name | Sheriese M Bone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366021487 PECOS PAC ID: 2163889320 Enrollment ID: I20230601002643 |
Marshall County Family Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 543 Powell Ln, Benton, KY 42025 Phone: 270-527-2273 Fax: 270-527-9602 | |
Chunn Enterprises, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 George Mcclain Dr, Benton, KY 42025 Phone: 270-527-2411 Fax: 270-527-8734 | |
Fast Pace Kentucky, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 Main St, Benton, KY 42025 Phone: 270-906-0369 | |
Regional Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 83 Wellness Way, Benton, KY 42025 Phone: 270-527-8601 Fax: 270-527-9615 | |
Marshall County Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 145 Vine Street, Benton, KY 42025 Phone: 270-527-2273 | |
Benton Rural Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 543 Powell Ln, Benton, KY 42025 Phone: 270-415-7070 Fax: 270-415-4071 | |
Life Coordinated Commonwealth Pace Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E 11th St, Benton, KY 42025 Phone: 855-209-5451 |