| Bethany Marie Klett-kimble, | |
|
835 S Van Buren St, Green Bay, WI 54301-3526 | |
| (920) 433-0111 | |
| Not Available |
| Full Name | Bethany Marie Klett-kimble |
|---|---|
| Gender | Female |
| Speciality | Pediatrics - Neonatal-perinatal Medicine |
| Location | 835 S Van Buren St, Green Bay, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679068381 | NPI | - | NPPES |
| 1679068381 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 75204 (Wisconsin) | Secondary |
| 2080N0001X | Pediatrics - Neonatal-perinatal Medicine | 75204 (Wisconsin) | Primary |
| Entity Name | The Medical College Of Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
| Mailing Address | Practice Location Address |
|---|---|
| Bethany Marie Klett-kimble, 9000 W Wisconsin Ave, Milwaukee, WI 53226-4874 Ph: (414) 266-6820 | Bethany Marie Klett-kimble, 835 S Van Buren St, Green Bay, WI 54301-3526 Ph: (920) 433-0111 |
Mary Lynn Bartel, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 835 S Van Buren St, Room 1041, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-496-4705 | |
Kathleen Marie Barkow, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1821 S Webster Ave, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-436-1319 | |
Kristina Ann Houn, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2793 Lineville Rd, Green Bay, WI 54313 Phone: 920-496-4700 | |
George E Whetmore, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1821 S Webster Ave, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-436-1319 | |
Ralph Joseph Vardis, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 835 S Van Buren St, Green Bay, WI 54301 Phone: 920-496-4700 Fax: 920-433-8569 | |
Dr. Robert Michael Rock Jr., MD Pediatrics Medicare: Medicare Enrolled Practice Location: 835 S. Vanburen St., Green Bay, WI 54301 Phone: 920-433-8360 Fax: 920-431-3163 | |
James F Winston, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 835 S Van Buren St, Green Bay, WI 54301 Phone: 920-433-8360 |