Alec Samuel Small, DO | |
10400 75th St, Kenosha, WI 53142-7884 | |
(262) 948-5600 | |
Not Available |
Full Name | Alec Samuel Small |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 10400 75th St, Kenosha, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700464526 | NPI | - | NPPES |
100278001 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 036.166609 (Illinois) | Secondary |
207P00000X | Emergency Medicine | 81508-21 (Wisconsin) | Primary |
Entity Name | Osf Multi-specialty Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
Mailing Address | Practice Location Address |
---|---|
Alec Samuel Small, DO 808 S Wood St Rm 469a, Chicago, IL 60612-7300 Ph: () - | Alec Samuel Small, DO 10400 75th St, Kenosha, WI 53142-7884 Ph: (262) 948-5600 |
David Eric Farkas, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Aurora Medical Center, Kenosha, WI 53142 Phone: 262-697-7000 Fax: 630-734-1560 | |
Ms. Kimberly Roberson, PA Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-5600 | |
Dr. Reena Meghan Underiner, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-5600 | |
Terry Zehr, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-7000 | |
Manuel A. Rivera, M.D. Emergency Medicine Medicare: May Accept Medicare Assignments Practice Location: 4536 22nd Ave, Kenosha, WI 53140 Phone: 262-656-0044 Fax: 262-653-2218 | |
Mounica D Robinson, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 10400 75th St, Kenosha, WI 53142 Phone: 262-948-5600 | |
Benjamin A Feinzimer, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6308 8th Ave, Kenosha, WI 53143 Phone: 414-290-6720 Fax: 414-290-6755 |