Sean Ellis Mcmicken, NP | |
2200 Osprey Blvd, Bartow, FL 33830-3308 | |
(800) 893-9698 | |
Not Available |
Full Name | Sean Ellis Mcmicken |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 2200 Osprey Blvd, Bartow, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1598848327 | NPI | - | NPPES |
302720100 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | ARNP3170022 (Florida) | Primary |
Entity Name | Polk Emergency Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558338574 PECOS PAC ID: 0547241598 Enrollment ID: O20050506000658 |
Mailing Address | Practice Location Address |
---|---|
Sean Ellis Mcmicken, NP 200 Corporate Blvd., Suite 201, Lafayette, LA 70508 Ph: (800) 893-9698 | Sean Ellis Mcmicken, NP 2200 Osprey Blvd, Bartow, FL 33830-3308 Ph: (800) 893-9698 |
Dr. James Ronald Smith Ii, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2200 Osprey Blvd, Bartow, FL 33830 Phone: 863-519-1440 Fax: 863-519-1432 | |
Brian Carl Ratzel, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2200 Osprey Blvd, Bartow, FL 33830 Phone: 941-746-2065 | |
William L. Jones, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2200 Osprey Blvd, Bartow, FL 33830 Phone: 863-644-8016 |