Dr Nikolo C Quinones, MD | |
1300 South Drive, Winnebago, WI 54985-0009 | |
(920) 235-4910 | |
(920) 237-2043 |
Full Name | Dr Nikolo C Quinones |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Location | 1300 South Drive, Winnebago, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1750498077 | NPI | - | NPPES |
711290189 | Other | WI | MEDICARE PTAN |
450030793 | Other | WI | MEDICARE PTAN |
32449800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 39923 (Wisconsin) | Primary |
283Q00000X | Psychiatric Hospital | 39923 (Wisconsin) | Secondary |
Entity Name | State Of Wisconsin |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437253648 PECOS PAC ID: 9234181751 Enrollment ID: O20050214000153 |
Mailing Address | Practice Location Address |
---|---|
Dr Nikolo C Quinones, MD Po Box 9, Winnebago, WI 54985-0009 Ph: (920) 235-4910 | Dr Nikolo C Quinones, MD 1300 South Drive, Winnebago, WI 54985-0009 Ph: (920) 235-4910 |
C Harold Mork, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1300 South Dr., Winnebago, WI 54985 Phone: 920-235-4910 Fax: 920-236-2931 | |
Alejandro A Eisma, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1300 South Drive, Winnebago Mental Health Institute, Winnebago, WI 54985 Phone: 920-235-4910 Fax: 920-236-2931 | |
Dr. James L Basiliere, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1300 South Dr., Winnebago Mental Health Institute, Winnebago, WI 54985 Phone: 920-235-4910 Fax: 920-236-2931 |