Provider Demographics
NPI:1891747432
Name:MCGUFFIN, MARCELLA S (PA-C)
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:S
Last Name:MCGUFFIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2379
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2379
Mailing Address - Country:US
Mailing Address - Phone:606-408-6200
Mailing Address - Fax:606-408-6612
Practice Address - Street 1:613 23RD ST STE 340
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41101-2879
Practice Address - Country:US
Practice Address - Phone:606-326-9441
Practice Address - Fax:606-326-0404
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01369363AM0700X
KYPA458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2823403Medicaid
OHPENDINGOtherMOLINA OF OHIO
WV1245265206OtherCIGNA
WVPENDINGOtherHEALTHNET TRICARE
WV1245265206OtherBRICKSTREET
WV1245265206OtherAETNA
WV1891747432OtherWELLS FARGO PEIA
OH2823403Medicaid
WVPENDINGOtherUS DEPT OF LABOR
KYP01320OtherUPIN
WV1891747432OtherMOUNTAIN STATE BCBS
WVPENDINGOtherCARELINK
OHPENDINGOtherOHIO BWC
WVPENDINGOtherSELECT NET
WV1891747432Other4MOST
OH200206OtherUNISON HEALTH PLAN
WV1891747432Other4MOST