Kohldon Carter Boydston, MD | |
2600 N Mayfair Rd Ste 545, Wauwatosa, WI 53226-1306 | |
(414) 476-0430 | |
Not Available |
Full Name | Kohldon Carter Boydston |
---|---|
Gender | Male |
Speciality | Urology |
Experience | 8 Years |
Location | 2600 N Mayfair Rd Ste 545, Wauwatosa, Wisconsin |
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 |
---|---|---|---|
1518320100 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 76733 (Wisconsin) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ascension All Saints Hospital | Racine, WI | Hospital |
Ascension Se Wisconsin Hospital - St Joseph Campus | Milwaukee, WI | Hospital |
Ascension St Francis Hospital | Milwaukee, WI | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Metropolitan Urology Group, Sc | 6002703840 | 5 |
Wheaton Franciscan Medical Group Inc | 8628980943 | 565 |
Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
Entity Name | Metropolitan Urology Group, Sc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336201110 PECOS PAC ID: 6002703840 Enrollment ID: O20040304000421 |
Mailing Address | Practice Location Address |
---|---|
Kohldon Carter Boydston, MD 2301 Erwin Rd, Durham, NC 27705-4699 Ph: (919) 684-8111 | Kohldon Carter Boydston, MD 2600 N Mayfair Rd Ste 545, Wauwatosa, WI 53226-1306 Ph: (414) 476-0430 |
William H Annesley Jr., MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1547 Upper Pkwy S, Wauwatosa, WI 53213 Phone: 414-254-5610 Fax: 414-755-7576 | |
John Patrick Walsh, MD Urology Medicare: Medicare Enrolled Practice Location: 2600 N Mayfair Rd, Suite 545, Wauwatosa, WI 53226 Phone: 414-476-0430 Fax: 414-476-3242 | |
Christopher John Walsh, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 2600 N Mayfair Rd, Ste 545, Wauwatosa, WI 53226 Phone: 414-476-0430 Fax: 414-476-3242 |