Dr Travis G Petricek, MD | |
2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 | |
(414) 649-6577 | |
Not Available |
Full Name | Dr Travis G Petricek |
---|---|
Gender | Male |
Speciality | General Surgery |
Experience | 20 Years |
Location | 2900 W Oklahoma 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 |
---|---|---|---|
1558546598 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208600000X | Surgery | 200900109 (North Carolina) | Secondary |
208600000X | Surgery | 036156249 (Illinois) | Secondary |
208600000X | Surgery | 74530 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Memorial Hospital Of Carbondale | Carbondale, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Southern Illinois Medical Services Nfp | 3678677390 | 252 |
Entity Name | Southern Illinois Medical Services Nfp |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595 |
Mailing Address | Practice Location Address |
---|---|
Dr Travis G Petricek, MD 3301 W Forest Home Ave, Milwaukee, WI 53215-2843 Ph: (414) 649-6577 | Dr Travis G Petricek, MD 2900 W Oklahoma Ave, Milwaukee, WI 53215-4330 Ph: (414) 649-6577 |
Dr. Simin Golestani, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-5800 Fax: 414-805-8097 | |
Jiro Kimura, Surgery Medicare: Not Enrolled in Medicare Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-805-6400 Fax: 414-955-0213 | |
Dr. David L Larson, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 8700 Watertown Plank Road, Wisconsin Athletic Club Bldg, Milwaukee, WI 53226 Phone: 414-805-3666 | |
Dr. John J Aiken, MD Surgery Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Surgery, Milwaukee, WI 53226 Phone: 414-266-6550 Fax: 414-266-6579 | |
Dr. Jeremy Holzmacher Levin, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 9200 W Wisconsin Ave, Milwaukee, WI 53226 Phone: 414-955-1700 Fax: 414-955-0072 | |
Dr. Keith T Oldham, MD Surgery Medicare: Medicare Enrolled Practice Location: 9000 W Wisconsin Ave, Pediatric Surgery, Milwaukee, WI 53226 Phone: 414-266-6550 Fax: 414-266-6579 | |
William R Deshur, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 2801 W Kk River Pkwy, Suite 330, Milwaukee, WI 53215 Phone: 414-649-3240 Fax: 414-649-3244 |