Kevin Creelman (NPI# 1538205307, PAC ID# 7214962125) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL PRACTICE.
| Nation Provider ID (NPI) | 1538205307 |
| PAC ID by PECOS | 7214962125 |
| Professional Enrollment ID | I20050929000341 |
| Full Name | Kevin Creelman |
| Address |
104 Ctr Ave Suite 100 Kodiak AK 99615-6393 |
| Gender | M |
| Credential | MD |
| Medical School | COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS |
| Graduation Year | 1973 |
| Primary Specialty | GENERAL PRACTICE |
| Secondary Specialties | FAMILY MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 021306 | PROVIDENCE KODIAK ISLAND MEDICAL CTR |
| Address | Phone | Organization |
|---|---|---|
| 104 Ctr Ave, Suite 100, Kodiak, AK 99615-6393 |
| Street Address |
104 CTR AVE SUITE 100 |
| City | KODIAK |
| State | AK |
| Zip | 99615-6393 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerimiah L Myers | Optometry | 214 W Rezanof Dr, Suite 1, Kodiak, AK 99615-6044 | |
| John M Weaver | Clinical Social Worker | Providence Health and Services Washington | 717 E Rezanof Dr, Kodiak, AK 99615-6416 |
| Welby N Jensen | Psychiatry | Providence Health and Services Washington | 717 E Rezanof Dr, Kodiak, AK 99615-6416 |
| Rae Jean Blaschka | Nurse Practitioner | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Mark E Withrow | General Practice | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Carol L Juergens | Internal Medicine | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Laura M Creighton | Chiropractic | 814 E Rezanof Dr, Kodiak, AK 99615-6599 | |
| Janet Abadir | General Surgery | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Melissa K Witteveen | Physician Assistant | Kodiak Island Healthcare Foundation | 1911 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Stephen S Burnside | Internal Medicine | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Find all physicians in zip 99615 | |||
| City | KODIAK |
| Zip Code | 99615 |
| Specialty | GENERAL PRACTICE |
| City + Specialty | KODIAK + GENERAL PRACTICE |
Please comment or provide details below to improve the information on Kevin Creelman.
| 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.