| Alicia Loch Pino, DO | |
| 3011 N Michigan St, Pittsburg, KS 66762-2546 | |
| (620) 231-9873 | |
| Not Available | 
| Full Name | Alicia Loch Pino | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 3011 N Michigan St, Pittsburg, Kansas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1255791273 | NPI | - | NPPES | 
| 201240540A | Medicaid | KS | |
| 110931172 | Other | KS | MEDICARE | 
| 200717690B | Medicaid | OK | |
| 200071422 | Medicaid | MO | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 0540410 (Kansas) | Primary | 
| Entity Name | Community Health Center Of Southeast Kansas Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1669474425 PECOS PAC ID: 7911816392 Enrollment ID: O20040209000163 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Alicia Loch Pino, DO Po Box 1832, Pittsburg, KS 66762-1832 Ph: (620) 231-9873 | Alicia Loch Pino, DO 3011 N Michigan St, Pittsburg, KS 66762-2546 Ph: (620) 231-9873 | 
| Dr. Casey Virginia Hudson, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9873 Fax: 859-372-5004 | |
| Susan Louise Mcnaughton Pence, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9879 Fax: 620-231-5062 | |
| Dr. Krista Lynn Williams-mijares, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9873 Fax: 620-231-2808 | |
| Dr. Jessilyn Ranae Humble, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2711 S Rouse St Ste B, Pittsburg, KS 66762 Phone: 620-235-7612 Fax: 620-235-7613 | |
| Roylan James Mcdaniel, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2401 S Tucker Ave Ste 4, Pittsburg, KS 66762 Phone: 620-231-2490 Fax: 620-231-3920 |