Kevin P Scully (NPI# 1730199563, PAC ID# 1355329756) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1730199563 |
| PAC ID by PECOS | 1355329756 |
| Professional Enrollment ID | I20040712001149 |
| Full Name | Kevin P Scully |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Address |
2210 Three Lakes Pkwy Suite 100 Tyler TX 75703-0642 |
| Phone Number | 9037474050 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4486915600 |
| Number of Group Practice Members | 163 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 18118 Fm 344, Ut Health East Texas Physicians, Flint, TX 75762-6010 | 9038253292 | ETMC PHYSICIAN GROUP, INC. |
| 2210 Three Lakes Pkwy, Suite 100, Tyler, TX 75703-0642 | 9037474050 | ETMC PHYSICIAN GROUP, INC. |
| 6210 S Broadway Ave, Ut Health East Texas Physicians, Tyler, TX 75703-4413 | 9035792700 | ETMC PHYSICIAN GROUP, INC. |
| Organization Legal Name | ETMC PHYSICIAN GROUP, INC. |
| Physicians | 178 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Varalaxmi Nannaka | Pulmonary Disease | Etmc Physician Group, Inc. | 305 Cottage Rd, Carthage, TX 75633-1511 |
| Betsy Jill Chappell | Nurse Practitioner | Etmc Physician Group, Inc. | 406 E Hwy 243, Canton, TX 75103-2409 |
| Andrea Corine Cooley | Cardiac Surgery | Etmc Physician Group, Inc. | 1000 E 5th St, Suite 400, Tyler, TX 75701-3362 |
| Jason S Murry | General Surgery | Etmc Physician Group, Inc. | 1020 E Idel St, Ut Health East Texas Physicians, Tyler, TX 75701-2024 |
| Ronald J Pinkenburg | Ophthalmology | Etmc Physician Group, Inc. | 16911 Village Lake Dr, Lindale, TX 75771-5065 |
| Francine Fraser Mccain | Obstetrics/gynecology | Etmc Physician Group, Inc. | 1336 S Palestine St, Athens, TX 75751-3621 |
| Lori Fuquay | Nurse Practitioner | Etmc Physician Group, Inc. | 601 Hwy 110 N, Suite O, Whitehouse, TX 75791-3037 |
| Michael Jason Chastant | Nurse Practitioner | Etmc Physician Group, Inc. | 2608 Mcdonald Rd, Tyler, TX 75701-5934 |
| Joseph Leonard Decarlo | Urology | Etmc Physician Group, Inc. | 911 S Beckham Ave, Tyler, TX 75701-1907 |
| Eric D Reed | Otolaryngology | Etmc Physician Group, Inc. | 301 W 19th St, Mt Pleasant, TX 75455-2322 |
| Street Address |
2210 THREE LAKES PKWY SUITE 100 |
| City | TYLER |
| State | TX |
| Zip | 75703-0642 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sujatha A White | Internal Medicine | Etmc Physician Group, Inc. | 2210 Three Lakes Pkwy, Suite 100, Tyler, TX 75703-0642 |
| Bryan T Hyland | Family Medicine | Etmc Physician Group, Inc. | 2210 Three Lakes Pkwy, Suite 100, Tyler, TX 75703-0642 |
| Jessica A Bracks | Family Medicine | Etmc Physician Group, Inc. | 2210 Three Lakes Pkwy, Suite 100, Tyler, TX 75703-0642 |
| Brandi Michelle Pate | Nurse Practitioner | Etmc Physician Group, Inc. | 2210 Three Lakes Pkwy, Suite 100, Tyler, TX 75703-0642 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tanner Lee Hays | Chiropractic | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | |
| Wilson Krezdorn | Mass Immunization Roster Biller | 2130 W Grande Blvd, Rose City Pharmacy, Tyler, TX 75703-0563 | |
| Luther B Bratcher | Chiropractic | 2140 W Grande Blvd A, Tyler, TX 75703-0563 | |
| William Xavier Bratcher | Chiropractic | 2140 W Grande Blvd A, Tyler, TX 75703-0563 | |
| Kevin G May | Internal Medicine | 6723 Highlands Ct, Tyler, TX 75703-0584 | |
| James E Kent | Podiatry | 6603 Oak Hill Blvd, Tyler, TX 75703-0586 | |
| Daniel R Canchola | Family Medicine | Trinity Physical Medicine and Rehab Pllc | 7062 Highlands Ln, Tyler, TX 75703-0590 |
| Zalinda Colston | Nurse Practitioner | Trinity Physical Medicine and Rehab Pllc | 7062 Highlands Ln, Tyler, TX 75703-0590 |
| Benjamin Bach | Physician Assistant | Trinity Physical Medicine and Rehab Pllc | 7062 Highlands Ln, Tyler, TX 75703-0590 |
| Michelle K Dunn | Chiropractic | Trinity Physical Medicine and Rehab Pllc | 7062 Highlands Ln, Tyler, TX 75703-0590 |
| Find all physicians in zip 75703 | |||
| City | TYLER |
| Zip Code | 75703 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | TYLER + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.