Mr Justin Matthew Kitson, CAA | |
225 S Executive Dr, Brookfield, WI 53005-4257 | |
(262) 787-6758 | |
Not Available |
Full Name | Mr Justin Matthew Kitson |
---|---|
Gender | Male |
Speciality | Anesthesiologist Assistant |
Location | 225 S Executive Dr, Brookfield, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821459710 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367H00000X | Anesthesiologist Assistant | AA2020-002 (New Mexico) | Secondary |
367H00000X | Anesthesiologist Assistant | (Wisconsin) | Primary |
Entity Name | St. Vincent Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1578587150 PECOS PAC ID: 6608775135 Enrollment ID: O20040105000372 |
Entity Name | Unm Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1831218627 PECOS PAC ID: 4981795267 Enrollment ID: O20070801000589 |
Entity Name | Three Crosses Regional Hospital Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1487248050 PECOS PAC ID: 1254758667 Enrollment ID: O20210405001637 |
Entity Name | Three Crosses Anesthesia Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1255906855 PECOS PAC ID: 9638546849 Enrollment ID: O20221101000947 |
Mailing Address | Practice Location Address |
---|---|
Mr Justin Matthew Kitson, CAA 5970 S Brandtwood Ct, Cudahy, WI 53110-3405 Ph: (402) 992-2997 | Mr Justin Matthew Kitson, CAA 225 S Executive Dr, Brookfield, WI 53005-4257 Ph: (262) 787-6758 |
Tia Covington Harris, AA-C Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 225 S Executive Dr, Brookfield, WI 53005 Phone: 262-787-6758 | |
Dylan Bray, AA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: 225 S Executive Dr, Brookfield, WI 53005 Phone: 608-770-0908 |