Jason W Wickersham, MD | |
401 W Glynn Dr, Parkston, SD 57366-9605 | |
(605) 928-3311 | |
(605) 928-7368 |
Full Name | Jason W Wickersham |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 23 Years |
Location | 401 W Glynn Dr, Parkston, South Dakota |
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 |
---|---|---|---|
1073594172 | NPI | - | NPPES |
5340070 | Medicaid | SD | |
5340340 | Medicaid | SD | |
4995341 | Other | SD | WELLMARK |
5611620 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5450 (South Dakota) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Avera At Home | Mitchell, SD | Home health agency |
Avera At Home | Mitchell, SD | Hospice |
Avera St Benedict Health Center - Cah | Parkston, SD | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Benedict Health Center | 4880507672 | 11 |
Entity Name | St Benedict Health Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295758266 PECOS PAC ID: 4880507672 Enrollment ID: O20040129001118 |
Mailing Address | Practice Location Address |
---|---|
Jason W Wickersham, MD 401 W Glynn Dr, Parkston, SD 57366-9605 Ph: (605) 928-3311 | Jason W Wickersham, MD 401 W Glynn Dr, Parkston, SD 57366-9605 Ph: (605) 928-3311 |
Richard W. Honke Ii, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 401 W Glynn Dr, Parkston, SD 57366 Phone: 605-928-3311 Fax: 605-928-7368 | |
Antoinette J Vander Pol, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 W Glynn Dr, Parkston, SD 57366 Phone: 605-928-3311 Fax: 605-928-7368 | |
Paul David Berndt, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 401 W Glynn Dr, Parkston, SD 57366 Phone: 605-928-7961 Fax: 605-928-4417 |