Jerick C Pacheco, MD | |
528 N 1st St, Vincennes, IN 47591-1402 | |
(812) 882-4434 | |
(812) 885-6318 |
Full Name | Jerick C Pacheco |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 528 N 1st St, Vincennes, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992781181 | NPI | - | NPPES |
200869750A | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 35081844P (Ohio) | Secondary |
208000000X | Pediatrics | 01063831A (Indiana) | Primary |
Entity Name | Good Samaritan Hospital Physician Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649432071 PECOS PAC ID: 3971671330 Enrollment ID: O20081013000182 |
Mailing Address | Practice Location Address |
---|---|
Jerick C Pacheco, MD 528 N 1st St, Vincennes, IN 47591-1402 Ph: (812) 882-4434 | Jerick C Pacheco, MD 528 N 1st St, Vincennes, IN 47591-1402 Ph: (812) 882-4434 |
Noel O Suanes, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 528 N 1st St, Vincennes, IN 47591 Phone: 812-882-4434 Fax: 812-885-6318 | |
Dr. Heather Ruthann Nichols, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 528 N 1st St, Vincennes, IN 47591 Phone: 812-882-4434 Fax: 812-885-6318 | |
Kenneth W Buehlman, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 528 N 1st St, Vincennes, IN 47591 Phone: 812-882-4434 Fax: 812-885-6318 | |
Dr. Kathleen B Stutz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 520 S 7th St, Vincennes, IN 47591 Phone: 812-882-5220 Fax: 812-885-3769 |