Dr Eliot Martin Wickliff, MD | |
9200 W Wisconsin Ave, Department Of Anesthesiology, Milwaukee, WI 53226-3522 | |
(414) 805-8700 | |
(414) 259-1522 |
Full Name | Dr Eliot Martin Wickliff |
---|---|
Gender | Male |
Speciality | Pain Management |
Experience | 15 Years |
Location | 9200 W Wisconsin Ave, Milwaukee, Wisconsin |
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 |
---|---|---|---|
1225261324 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 125057068 (Illinois) | Secondary |
207L00000X | Anesthesiology | 56537 (Wisconsin) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | Q3833 (Texas) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Providence Health Center | Waco, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Providence Health Alliance | 6305731068 | 111 |
Entity Name | Providence Health Alliance |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932210838 PECOS PAC ID: 6305731068 Enrollment ID: O20040220000307 |
Mailing Address | Practice Location Address |
---|---|
Dr Eliot Martin Wickliff, MD Po Box 18962, Belfast, ME 04915-4084 Ph: (800) 566-5050 | Dr Eliot Martin Wickliff, MD 9200 W Wisconsin Ave, Department Of Anesthesiology, Milwaukee, WI 53226-3522 Ph: (414) 805-8700 |
Dr. Jeffrey T Lyvers, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2900 W Oklahoma Ave, Milwaukee, WI 53215 Phone: 414-649-6000 | |
Dr. Nosheen Hasan, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 7235 W Appleton Ave, Sutie 102, Milwaukee, WI 53216 Phone: 414-444-8670 Fax: 414-444-8678 | |
Dr. Quinn Hogan, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Department Of Anesthesiology, Milwaukee, WI 53226 Phone: 414-805-8700 Fax: 414-259-1522 | |
Dr. Stephen R Thompson, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2025 E Newport Ave, Milwaukee, WI 53211 Phone: 414-961-3300 | |
Dr. Christina D Diaz, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 9200 W Wisconsin Ave, Department Of Anesthesiology, Milwaukee, WI 53226 Phone: 414-805-8700 Fax: 414-259-1522 | |
Dr. John V Selthafner, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-8700 Fax: 414-259-1522 | |
Anne M Fagan, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 10200 W Innovation Dr, Milwaukee, WI 53226 Phone: 414-302-9196 |