Thomas E Kottke, MD | |
640 Jackson Street, Mc 11102h, St Paul, MN 55101-2502 | |
(651) 254-5175 | |
(651) 254-1603 |
Full Name | Thomas E Kottke |
---|---|
Gender | Male |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 640 Jackson Street, St Paul, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255307617 | NPI | - | NPPES |
363773500 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 24324 (Minnesota) | Primary |
207RC0000X | Internal Medicine - Cardiovascular Disease | 47187-0Z0 (Wisconsin) | Secondary |
Entity Name | Group Health Plan Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1710924683 PECOS PAC ID: 1759293954 Enrollment ID: O20031105000417 |
Mailing Address | Practice Location Address |
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Thomas E Kottke, MD 640 Jackson St, Mail Stop 11102h, Saint Paul, MN 55101-2502 Ph: (651) 254-5175 | Thomas E Kottke, MD 640 Jackson Street, Mc 11102h, St Paul, MN 55101-2502 Ph: (651) 254-5175 |
William Robert Jahnke Ii, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 360 Sherman St, Ste 250, St Paul, MN 55102 Phone: 651-772-6251 Fax: 651-224-9661 | |
Dr. Neil P Phelan, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2550 University Ave West, Suite 423 South, St Paul, MN 55114 Phone: 612-870-5557 Fax: 612-870-5857 | |
Dr. Josaleen Muzquiz Davis, MD Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 1055 Westgate Dr, Ste 100, St Paul, MN 55114 Phone: 122-627-8006 | |
Randolph W Hurley, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 640 Jackson Street, Mc 11503f, St Paul, MN 55101 Phone: 651-254-3448 Fax: 651-254-3470 | |
Jeffrry P Jaffe, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 640 Jackson St, Mc 11530f, St Paul, MN 55101 Phone: 651-254-3448 Fax: 651-254-3470 | |
Ghaziuddin A Qadri, MBBS Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 640 Jackson Street, Mc11503f, St Paul, MN 55101 Phone: 123-123-1234 Fax: 651-254-3662 | |
Mohamed A Hagi Aden, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 640 Jackson Street, St Paul, MN 55101 Phone: 123-123-1234 Fax: 651-254-3662 |