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NPI Code Detail

MEDICARE: CELENA D MCCANDLESS PA

MEDICARE: CELENA D MCCANDLESS PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant10002042AIN

General Provider Information

NPI Number : 1194146787
Entity Type Code : Individual
Provider Name (Legal Business Name) : CELENA D MCCANDLESS PA
Provider Business Mailing Address
First Line : PO BOX 1510
Second Line :
City : EVANSVILLE
State : IN
Zip : 47706-1510
Country : US
Telephone Number : 812-749-6187
Fax Number :
Provider Business Practice Location Address
First Line : 1204 WILLIAMS ST
Second Line :
City : OAKLAND CITY
State : IN
Zip : 47660-1001
Country : US
Telephone Number : 812-749-6187
Fax Number : 812-749-4966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2013
Last Update Date : 03/28/2019

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Directions to “ CELENA D MCCANDLESS PA” Practice Location

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