Mallory Sprague (NPI# 1366891632, PAC ID# 0446683312) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1366891632 |
| PAC ID by PECOS | 0446683312 |
| Professional Enrollment ID | I20191206000869 |
| Full Name | Mallory Sprague |
| Organization Legal Name | CANTON-POTSDAM HOSPITAL |
| Address |
49 Lawrence Ave Potsdam NY 13676-1889 |
| Phone Number | 3152615550 |
| Gender | F |
| Graduation Year | 2016 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6204827280 |
| Number of Group Practice Members | 145 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 330197 | CANTON-POTSDAM HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 49 Lawrence Ave, Potsdam, NY 13676-1889 | 3152615550 | CANTON-POTSDAM HOSPITAL |
| Organization Legal Name | CANTON-POTSDAM HOSPITAL |
| Physicians | 154 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Grimshaw | Family Medicine | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Hamza Tarek Malek | Neurology | Canton-potsdam Hospital | 6119 Us Hwy 11, Canton, NY 13617-3991 |
| Amanda L Hance | Nurse Practitioner | Canton-potsdam Hospital | 77 W Barney St, Cph Specialty Suites At Gvnr, Governed, NY 13642-1040 |
| Heather Munz | Physician Assistant | Canton-potsdam Hospital | 80 E Main St, Canton, NY 13617-1450 |
| Krista Fuller | Certified Registered Nurse Anesthetist (crna) | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Eleazar Ogarro | Obstetrics/gynecology | Canton-potsdam Hospital | 190 Outer Main St, Potsdam, NY 13676-2356 |
| Chinyere Mgbahuru Nwosu | Internal Medicine | Canton-potsdam Hospital | 15 Raymond St, Potsdam, NY 13676-1163 |
| Julie Lynn Lawless | Clinical Social Worker | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Robert A Worden | Certified Registered Nurse Anesthetist (crna) | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Aaron R Cooper | Physician Assistant | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Street Address |
49 LAWRENCE AVE |
| City | POTSDAM |
| State | NY |
| Zip | 13676-1889 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Grimshaw | Family Medicine | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Vineet Bansal | Family Medicine | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Tatiana Dicoby | Obstetrics/gynecology | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Alecia Acee Vanwagner | Family Medicine | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Sonja Kocan | Nurse Practitioner | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Jayaram Radhakrishnan | Cardiovascular Disease (cardiology) | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| John Duffy | Family Medicine | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Paul C O Donnell | Optometry | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| David Bass | Cardiovascular Disease (cardiology) | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Kris A Vanwagner | Ophthalmology | Canton-potsdam Hospital | 49 Lawrence Ave, Potsdam, NY 13676-1889 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chinyere Mgbahuru Nwosu | Internal Medicine | Canton-potsdam Hospital | 15 Raymond St, Potsdam, NY 13676-1163 |
| John H Kim | Gastroenterology | Canton-potsdam Hospital | 15 Raymond St, Potsdam, NY 13676-1163 |
| Rajiv S Shah | Internal Medicine | Canton-potsdam Hospital | 15 Raymond St, Potsdam, NY 13676-1163 |
| David A Nevins | Physician Assistant | Canton-potsdam Hospital | 15 Raymond St, Potsdam, NY 13676-1163 |
| James A Vecchio | Gastroenterology | Canton-potsdam Hospital | 15 Raymond St, Potsdam, NY 13676-1163 |
| Shawn T Burns | Chiropractic | 145 Market St, Suite 14, Potsdam, NY 13676-1244 | |
| Krista Fuller | Certified Registered Nurse Anesthetist (crna) | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Julie Lynn Lawless | Clinical Social Worker | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Robert A Worden | Certified Registered Nurse Anesthetist (crna) | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Aaron R Cooper | Physician Assistant | Canton-potsdam Hospital | 50 Leroy St, Potsdam, NY 13676-1786 |
| Find all physicians in zip 13676 | |||
| City | POTSDAM |
| Zip Code | 13676 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | POTSDAM + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mallory Sprague.
| 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.