Kenneth A Son, MD | |
1348 S 18th St, Fernandina Beach, FL 32034-4785 | |
(904) 227-2003 | |
(904) 277-2006 |
Full Name | Kenneth A Son |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 44 Years |
Location | 1348 S 18th St, Fernandina Beach, Florida |
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 |
---|---|---|---|
1417048331 | NPI | - | NPPES |
00748833A | Medicaid | GA | |
TJ447 | Other | FL | MEDICARE HF |
P01265088 | Other | FL | RAILROAD MEDICARE |
004787700 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 043782 (Georgia) | Secondary |
208M00000X | Hospitalist | ME111180 (Florida) | Secondary |
208800000X | Urology | ME111180 (Florida) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Wellstar Spalding Regional Hospital | Griffin, GA | Hospital |
Phoebe Putney Memorial Hospital | Albany, GA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Wellstar Medical Group, Llc | 6709065402 | 1917 |
Entity Name | Wellstar Medical Group, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
Mailing Address | Practice Location Address |
---|---|
Kenneth A Son, MD Po Box 2421, Salt Lake City, UT 84110-2421 Ph: (904) 202-1034 | Kenneth A Son, MD 1348 S 18th St, Fernandina Beach, FL 32034-4785 Ph: (904) 227-2003 |
Blaine S. Kristo, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1348 S 18th St Ste 230, Fernandina Beach, FL 32034 Phone: 904-277-2003 Fax: 904-277-2006 | |
Margeaux Jenee Dennis, DO Urology Medicare: Medicare Enrolled Practice Location: 1348 S 18th St Ste 230, Fernandina Beach, FL 32034 Phone: 904-277-2003 Fax: 904-277-2006 |