Kenneth E Marnocha, MD | |
253 Sagamore Pkwy W, West Lafayette, IN 47906-1501 | |
(765) 448-8000 | |
Not Available |
Full Name | Kenneth E Marnocha |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 253 Sagamore Pkwy W, West Lafayette, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1699744342 | NPI | - | NPPES |
156682 | Other | IN | PHCS PID NUMBER |
10825542 | Other | IN | CAQH NUMBER |
000000202120 | Other | IN | ANTHEM PROVIDER NUMBER |
100320630 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 01031076A (Indiana) | Primary |
Entity Name | Arnett Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1164490843 PECOS PAC ID: 0749184380 Enrollment ID: O20031125000119 |
Mailing Address | Practice Location Address |
---|---|
Kenneth E Marnocha, MD Po Box 5545, Lafayette, IN 47903-5545 Ph: (765) 448-8000 | Kenneth E Marnocha, MD 253 Sagamore Pkwy W, West Lafayette, IN 47906-1501 Ph: (765) 448-8000 |
Paul E Timperman, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 | |
Phyllis Martin-simmerman, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 Fax: 765-448-8335 | |
Dr. Luke Gerges, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 | |
Dr. Imran Kazem, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 | |
Dr. Joshua Austin Nepute, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 | |
Jeffrey S. Cahoon, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 Fax: 765-446-7085 |