David J Licini, MD | |
1302 S Rogers St, Bloomington, IN 47403-4752 | |
(812) 333-2663 | |
(812) 676-4131 |
Full Name | David J Licini |
---|---|
Gender | Male |
Speciality | Orthopedic Surgery |
Experience | 17 Years |
Location | 1302 S Rogers St, Bloomington, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801086343 | NPI | - | NPPES |
201119230 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207XS0114X | Orthopaedic Surgery - Adult Reconstructive Orthopaedic Surgery | 01071339A (Indiana) | Secondary |
207X00000X | Orthopaedic Surgery | 01071339A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Indiana University Health Home Care | Indianapolis, IN | Home health agency |
Indiana University Health Bloomington Hospital | Bloomington, IN | Hospital |
Indiana University Health | Indianapolis, IN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Indiana University Health Southern Indiana Physicians Llc | 6204748197 | 449 |
Entity Name | Indiana University Health Southern Indiana Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1013953983 PECOS PAC ID: 6204748197 Enrollment ID: O20040423000556 |
Mailing Address | Practice Location Address |
---|---|
David J Licini, MD 250 N Shadeland Ave, Indianapolis, IN 46219-4959 Ph: () - | David J Licini, MD 1302 S Rogers St, Bloomington, IN 47403-4752 Ph: (812) 333-2663 |
Dr. Brandon Royce Hood, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2605 E Creeks Edge Dr, Bloomington, IN 47401 Phone: 812-333-2663 | |
Dr. Timothy Martin Steiner, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 583 S Clarizz Blvd, Bloomington, IN 47401 Phone: 812-333-2663 Fax: 812-349-6206 | |
Anthony A Mcpherron, DO Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2800 Rex Grossman Blvd, Bloomington, IN 47403 Phone: 317-944-9400 Fax: 317-963-1955 | |
Dr. Otto William Wickstrom Iii, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 583 S Clarizz Blvd, Bloomington, IN 47401 Phone: 812-333-2663 Fax: 812-349-9206 | |
Johnathon Patrick Shaffer, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 583 S Clarizz Blvd, Bloomington, IN 47401 Phone: 812-676-4460 Fax: 812-355-4092 | |
Dr. Gregory M Fox, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 639 S Walker St, Suite E, Bloomington, IN 47403 Phone: 812-333-4000 Fax: 812-333-0611 | |
James Robert Lindner, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 2605 E Creeks Edge Dr, Bloomington, IN 47401 Phone: 812-333-1933 Fax: 812-333-3991 |