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General NPI Number Information
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NPI Number | 1487022091
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Entity Type | Individual
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Provider Name | KEVIN E. FERRELL PA
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Gender | Male
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 50973 COUNTY ROAD 681
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City | LAWRENCE
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State | MI
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Zip | 49064-9048
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Country | US
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Telephone | 269-241-2220
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Fax | 269-674-4239
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Provider Business Mailing Address
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Address Line | 50973 COUNTY ROAD 681
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City | LAWRENCE
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State | MI
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Zip | 49064-9048
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Country | US
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Telephone | 517-898-7718
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Fax | 269-639-2818
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601007459
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License Number State | MI
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