Alicia Loch Pino, DO | |
3011 N Michigan St, Pittsburg, KS 66762-2546 | |
(620) 231-9873 | |
Not Available |
Full Name | Alicia Loch Pino |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 3011 N Michigan St, Pittsburg, Kansas |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255791273 | NPI | - | NPPES |
201240540A | Medicaid | KS | |
110931172 | Other | KS | MEDICARE |
200717690B | Medicaid | OK | |
200071422 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 0540410 (Kansas) | Primary |
Entity Name | Community Health Center Of Southeast Kansas Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669474425 PECOS PAC ID: 7911816392 Enrollment ID: O20040209000163 |
Mailing Address | Practice Location Address |
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Alicia Loch Pino, DO Po Box 1832, Pittsburg, KS 66762-1832 Ph: (620) 231-9873 | Alicia Loch Pino, DO 3011 N Michigan St, Pittsburg, KS 66762-2546 Ph: (620) 231-9873 |
Dr. Casey Virginia Hudson, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9873 Fax: 859-372-5004 | |
Susan Louise Mcnaughton Pence, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9879 Fax: 620-231-5062 | |
Krista Lynn Williams-mijares, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9873 Fax: 620-231-2808 | |
Dr. Jessilyn Ranae Humble, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2711 S Rouse St Ste B, Pittsburg, KS 66762 Phone: 620-235-7612 Fax: 620-235-7613 | |
Roylan James Mcdaniel, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2401 S Tucker Ave Ste 4, Pittsburg, KS 66762 Phone: 620-231-2490 Fax: 620-231-3920 |