Dr Michael Jason Walls, MD | |
320 Thomas More Pkwy, Suite 202, Crestview Hills, KY 41017-3410 | |
(859) 331-0432 | |
(859) 331-0956 |
Full Name | Dr Michael Jason Walls |
---|---|
Gender | Male |
Speciality | Interventional Pain Management |
Experience | 20 Years |
Location | 320 Thomas More Pkwy, Crestview Hills, Kentucky |
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 |
---|---|---|---|
1083888325 | NPI | - | NPPES |
9318357 | Other | AETNA PIN | |
CS1811400200 | Other | CARESOURCE ID | |
7100086870 | Medicaid | KY | |
000001148521 | Other | ANTHEM ID | |
0295938 | Medicaid | OH | |
300012365 | Medicaid | IN | |
003031812 | Other | UNITED HEALTHCARE PROVIDER ID NUMBER | |
15725575 | Other | KY | WELLCARE OF KENTUCKY PROVIDER ID NUMBER |
298418KYIP | Other | KY | AETNA BETTER HEALTH OF KENTUCKY PROVIDER ID NUMBER |
P02011197 | Other | KY | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208VP0014X | Pain Medicine - Interventional Pain Medicine | 42678 (Kentucky) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Carroll County Memorial Hospital | Carrollton, KY | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Commonwealth Pain Associates Pllc | 0941441919 | 112 |
Entity Name | Robert Klickovich |
---|---|
Entity Type | Practitioner - Anesthesiology |
Entity Identifiers | NPI Number: 1649204306 PECOS PAC ID: 9931106879 Enrollment ID: I20080214000023 |
Entity Name | Tristate Arthritis & Rheumatology Psc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851449425 PECOS PAC ID: 6901858364 Enrollment ID: O20050214000539 |
Entity Name | Commonwealth Pain Associates Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306280177 PECOS PAC ID: 0941441919 Enrollment ID: O20130802000577 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael Jason Walls, MD Po Box 21890, Belfast, ME 04915-4115 Ph: (502) 907-0356 | Dr Michael Jason Walls, MD 320 Thomas More Pkwy, Suite 202, Crestview Hills, KY 41017-3410 Ph: (859) 331-0432 |
Philip L Zaacks, MD Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 350 Thomas More Pkwy, Suite 160, Crestview Hills, KY 41017 Phone: 513-221-1100 |