| Hilsbos Family Care, Pllc | |
|
5 Erwin Ln Ste B Fairmont WV 26554-1376 | |
| (304) 612-9186 | |
| (304) 366-7763 |
| Full Name | Hilsbos Family Care, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5 Erwin Ln Ste B, Fairmont, West Virginia |
| Authorized Official Name and Position | Kenneth Hilsbos (SOLE MEMBER) |
| Authorized Official Contact | 3043667766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hilsbos Family Care, Pllc 5 Erwin Ln Ste B Fairmont WV 26554-1376 Ph: (304) 612-9186 | Hilsbos Family Care, Pllc 5 Erwin Ln Ste B Fairmont WV 26554-1376 Ph: (304) 612-9186 |
| NPI Number | 1134151228 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 06/21/2021 |
| Medicare PECOS PAC ID | 9830123009 |
|---|---|
| Medicare Enrollment ID | O20050927000325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134151228 | NPI | - | NPPES |
| 3810003579 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kenneth Hilsbos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912922980 PECOS PAC ID: 3678536935 Enrollment ID: I20041202000119 |
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