| Kenneth A Black, MD | |
|
3630 Willowcreek Rd, Portage, IN 46368-5075 | |
| (219) 759-1157 | |
| Not Available |
| Full Name | Kenneth A Black |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 3630 Willowcreek Rd, Portage, Indiana |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134184112 | NPI | - | NPPES |
| 100207860A | Medicaid | IN | |
| 000000521738 | Other | IN | ANTHEM |
| 5251392 | Other | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01024841 (Indiana) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth A Black, MD 3630 Willowcreek Rd, Portage, IN 46368-5075 Ph: (219) 759-1157 | Kenneth A Black, MD 3630 Willowcreek Rd, Portage, IN 46368-5075 Ph: (219) 759-1157 |
Dr. Adrienne Baksinski, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3283 Willowcreek Rd, Portage, IN 46368 Phone: 219-764-8439 Fax: 249-764-8463 | |
Gretchen M Haney, MSN, APRN, FNP-BC Family Medicine Medicare: Medicare Enrolled Practice Location: 6050 Sterling Creek Rd, Portage, IN 46368 Phone: 219-763-8112 | |
Dr. Frank X Weilnhammer, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 6050 Sterling Creek Rd, Portage, IN 46368 Phone: 219-763-8112 Fax: 219-764-5380 | |
Dr. Inderjit K Kapoor, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 6375 Us Highway 6, Portage, IN 46368 Phone: 219-762-3196 Fax: 219-763-6438 | |
Dr. Shane David Bush, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3630 Willowcreek Rd, Portage, IN 46368 Phone: 219-364-3700 | |
Julijana Obetkovska, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6050 Sterling Creek Rd, Portage, IN 46368 Phone: 219-763-8112 |