Kirkwood Medical Practice | |
865 Route 11 Kirkwood NY 13795 | |
(434) 420-0466 | |
Not Available |
Full Name | Kirkwood Medical Practice |
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Speciality | Clinic/Center |
Location | 865 Route 11, Kirkwood, New York |
Authorized Official Name and Position | Jemille Smith (OWNER) |
Authorized Official Contact | 4344200466 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kirkwood Medical Practice 865 Route 11 Kirkwood NY 13795 Ph: (434) 420-0466 | Kirkwood Medical Practice 865 Route 11 Kirkwood NY 13795 Ph: (434) 420-0466 |
NPI Number | 1497530463 |
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Provider Enumeration Date | 08/29/2023 |
Last Update Date | 08/29/2023 |
Medicare PECOS PAC ID | 4284083841 |
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Medicare Enrollment ID | O20231208001016 |
Identifier | Type | State | Issuer |
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1497530463 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Bilqees Abdallah |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336440130 PECOS PAC ID: 3870775679 Enrollment ID: I20110316000200 |
Provider Name | Jemille Smith |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1457550071 PECOS PAC ID: 1355589821 Enrollment ID: I20130523000454 |
Kirkwood Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Mile Point Plaza, Kirkwood, NY 13795 Phone: 607-775-1771 Fax: 607-775-5479 |