Dr Kennith Miller, DO | |
156 W Jefferson St, Spring Green, WI 53588-8005 | |
(608) 588-2600 | |
(608) 588-2644 |
Full Name | Dr Kennith Miller |
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Gender | Male |
Speciality | Family Medicine |
Location | 156 W Jefferson St, Spring Green, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992778484 | NPI | - | NPPES |
245694807 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 010090 (Missouri) | Primary |
Entity Name | Upland Hills Health Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821258740 PECOS PAC ID: 3072415553 Enrollment ID: O20081016000442 |
Mailing Address | Practice Location Address |
---|---|
Dr Kennith Miller, DO 156 W Jefferson St, Spring Green, WI 53588-8005 Ph: (608) 588-2600 | Dr Kennith Miller, DO 156 W Jefferson St, Spring Green, WI 53588-8005 Ph: (608) 588-2600 |
Ellen L Olson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 436 Sunrise Dr, Spring Green, WI 53588 Phone: 608-588-2502 | |
Cristine L Cornelius, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 150 E Jefferson St, Spring Green, WI 53588 Phone: 608-588-7413 Fax: 608-588-7609 | |
Luke W Fortney, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 436 Sunrise Dr, Spring Green, WI 53588 Phone: 608-588-2502 | |
Kay M Balink, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 150 E Jefferson St, Spring Green, WI 53588 Phone: 608-588-7413 Fax: 608-588-7609 | |
Mark G Timmerman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 436 Sunrise Dr, Spring Green, WI 53588 Phone: 608-588-2502 Fax: 608-588-7724 |