| Barton William Wild, MD | |
|
3770 Glenkerry Ct, Portage, MI 49024-0700 | |
| (269) 329-2887 | |
| (269) 329-2805 |
| Full Name | Barton William Wild |
|---|---|
| Gender | Male |
| Speciality | Pain Management |
| Experience | 21 Years |
| Location | 3770 Glenkerry Ct, Portage, Michigan |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710197579 | NPI | - | NPPES |
| 1710197579 | Medicaid | MI | |
| M91620016 | Other | MI | UHC COMMUNITY PLAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207LP2900X | Anesthesiology - Pain Medicine | 4301086518 (Michigan) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 4301086518 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Oaklawn Hospital | Marshall, MI | Hospital |
| Borgess Medical Center | Kalamazoo, MI | Hospital |
| Bronson Methodist Hospital | Kalamazoo, MI | Hospital |
| Bronson Battle Creek Hospital | Battle creek, MI | Hospital |
| Lakeland Hospital, St Joseph | St joseph, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Michigan Pain Consultants Pc | 3173590957 | 11 |
| Entity Name | Southern Michigan Pain Consultants Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538119391 PECOS PAC ID: 3173590957 Enrollment ID: O20040911000291 |
| Mailing Address | Practice Location Address |
|---|---|
| Barton William Wild, MD 5555 Glenwood Hills Pkwy Se Ste 2, Grand Rapids, MI 49512-2091 Ph: (616) 940-2662 | Barton William Wild, MD 3770 Glenkerry Ct, Portage, MI 49024-0700 Ph: (269) 329-2887 |
Charles Guernsey, DO Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 3770 Glenkerry Ct, Portage, MI 49024 Phone: 269-329-2887 Fax: 269-329-2805 |