| Dr David G Van De Wyngaerde, MD | |
|
340 S Willard St, Cottonwood, AZ 86326-4126 | |
| (928) 639-7960 | |
| Not Available |
| Full Name | Dr David G Van De Wyngaerde |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 39 Years |
| Location | 340 S Willard St, Cottonwood, Arizona |
| 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 |
|---|---|---|---|
| 1528065919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 2013 (North Carolina) | Secondary |
| 208600000X | Surgery | 201300063 (North Carolina) | Secondary |
| 207X00000X | Orthopaedic Surgery | 17528 (Arizona) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Valley View Medical Center | Fort mohave, AZ | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lakeside Orthopedic Institute Llc | 1052316445 | 21 |
| Entity Name | Lakeside Orthopedic Institute Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275564916 PECOS PAC ID: 1052316445 Enrollment ID: O20060918000307 |
| Entity Name | Hrmc, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003139387 PECOS PAC ID: 3072641265 Enrollment ID: O20100508000148 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David G Van De Wyngaerde, MD 1200 N Beaver St, Attn: Payer Credentialing, Flagstaff, AZ 86001-3118 Ph: (928) 213-6235 | Dr David G Van De Wyngaerde, MD 340 S Willard St, Cottonwood, AZ 86326-4126 Ph: (928) 639-7960 |
Jack Winfred Wylie, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 450 S Willard St, Suite 105, Cottonwood, AZ 86326 Phone: 928-634-1112 Fax: 928-634-1117 | |
Brian T Duggan, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 340 S Willard St, Cottonwood, AZ 86326 Phone: 928-639-6025 Fax: 928-634-1117 | |
Dr. William Hallier, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 340 S Willard St, Cottonwood, AZ 86326 Phone: 928-639-6025 Fax: 928-634-1117 | |
Dr. Allen D Boyd, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 450 S Willard St, Suite 105, Cottonwood, AZ 86326 Phone: 928-634-1112 Fax: 928-634-1117 |