| Gregory P Kezele Md Llc | |
|
36000 Euclid Ave Willoughby OH 44094-4625 | |
| (440) 918-6341 | |
| (440) 918-6342 |
| Full Name | Gregory P Kezele Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 36000 Euclid Ave, Willoughby, Ohio |
| Authorized Official Name and Position | Gregory P Kezele (OWNER) |
| Authorized Official Contact | 4404130499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory P Kezele Md Llc 601 Clinton Ln Highland Hts OH 44143-1962 Ph: (440) 413-0499 | Gregory P Kezele Md Llc 36000 Euclid Ave Willoughby OH 44094-4625 Ph: (440) 918-6341 |
| NPI Number | 1821728478 |
|---|---|
| Provider Enumeration Date | 06/15/2022 |
| Last Update Date | 06/15/2022 |
| Medicare PECOS PAC ID | 3072992130 |
|---|---|
| Medicare Enrollment ID | O20220620001493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821728478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Gregory P Kezele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972563997 PECOS PAC ID: 6204735582 Enrollment ID: I20040106000287 |
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Signature Health Medical Group, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38882 Mentor Ave, Willoughby, OH 44094 Phone: 440-953-9999 Fax: 440-918-3839 | |
Signature Health, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 38876 Mentor Avenue, Willoughby, OH 44094 Phone: 440-953-9999 Fax: 440-918-3839 |