Kevin M Ellsworth (NPI# 1669457024, PAC ID# 5890775027) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1669457024 |
| PAC ID by PECOS | 5890775027 |
| Professional Enrollment ID | I20040720001186 |
| Full Name | Kevin M Ellsworth |
| Address |
395 E 1400 Suite B Logan UT 84341-7575 |
| Phone Number | 4357525585 |
| Gender | M |
| Credential | OD |
| Medical School | SOUTHERN CALIFORNIA COLLEGE OF OPTOMETRY |
| Graduation Year | 1985 |
| Primary Specialty | OPTOMETRY |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 395 E 1400, Suite B, Logan, UT 84341-7575 | 4357525585 |
| Street Address |
395 E 1400 SUITE B |
| City | LOGAN |
| State | UT |
| Zip | 84341-7575 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danny E Spencer | Emergency Medicine | Sterling Physician Group Pllc | 1400 N 630 E, Suite 150, Logan, UT 84341 |
| Roger M Moczygemba | Emergency Medicine | Sterling Physician Group Pllc | 1400 N 630 E, Suite 150, Logan, UT 84341 |
| Robert P Young | Dermatology | Rocky Mountain Dermatology Inc | 1760 N 200, Suite 101, North Logan, UT 84341-1202 |
| Heather B Allred | Physician Assistant | Rocky Mountain Dermatology Inc | 1760 N 200, Suite 101, North Logan, UT 84341-1202 |
| Angela K Cronin | Physician Assistant | Rocky Mountain Dermatology Inc | 1760 N 200, Suite 101, North Logan, UT 84341-1202 |
| Scott Eric Macdonald | Physician Assistant | Rocky Mountain Dermatology Inc | 1760 N 200, Suite 101, North Logan, UT 84341-1202 |
| Christopher J Morgan | Nurse Practitioner | 2150 N Main St, Suite 10, North Logan, UT 84341-1740 | |
| Charles R Acevedo | Physical Therapy | Logan Physical Therapy PC | 2310 N 400 E C, North Logan, UT 84341-1743 |
| Jason Christiansen | Physical Therapy | Logan Physical Therapy PC | 2310 N 400 E C, North Logan, UT 84341-1743 |
| Ryan J Perry | Physical Therapy | Logan Physical Therapy PC | 2310 N 400 E C, North Logan, UT 84341-1743 |
| Find all physicians in zip 84341 | |||
| City | LOGAN |
| Zip Code | 84341 |
| Specialty | OPTOMETRY |
| City + Specialty | LOGAN + OPTOMETRY |
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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.