Healthcare Provider Details

I. General information

NPI: 1215611611
Provider Name (Legal Business Name): KAYLA M BINEGAR MPAS, PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 2ND ST # C
MARIETTA OH
45750-2123
US

IV. Provider business mailing address

611 2ND ST # C
MARIETTA OH
45750-2123
US

V. Phone/Fax

Practice location:
  • Phone: 304-629-7418
  • Fax:
Mailing address:
  • Phone: 304-629-7418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008337RX
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number50.008337RX
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number50.008337RX
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number444595
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: