| Dr Jerad E Widman, MD | |
|
22450 S Harrison St, Ste. 100, Spring Hill, KS 66083-3151 | |
| (913) 592-2720 | |
| (913) 592-2725 |
| Full Name | Dr Jerad E Widman |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 25 Years |
| Location | 22450 S Harrison St, Spring Hill, Kansas |
| 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 |
|---|---|---|---|
| 1083655039 | NPI | - | NPPES |
| 200300220D | Medicaid | KS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 04-30763 (Kansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ellett Memorial Hospital | Appleton city, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Community Memorial Hospital District | 0345153680 | 20 |
| Entity Name | Lincoln County Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1942265327 PECOS PAC ID: 0941118061 Enrollment ID: O20030908000008 |
| Entity Name | Lincoln County Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841248952 PECOS PAC ID: 0941118061 Enrollment ID: O20050225000744 |
| Entity Name | Shawnee Mission Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992735690 PECOS PAC ID: 9537119037 Enrollment ID: O20050701000310 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jerad E Widman, MD 22450 S Harrison St, Ste 100, Spring Hill, KS 66083-3151 Ph: (913) 592-2720 | Dr Jerad E Widman, MD 22450 S Harrison St, Ste. 100, Spring Hill, KS 66083-3151 Ph: (913) 592-2720 |
Jacquelyn Lea Allen, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 22450 S Harrison St Ste 100, Spring Hill, KS 66083 Phone: 913-592-2720 Fax: 913-592-2725 | |
Jennifer C Bulcock, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 22450 S Harrison St Ste 100, Spring Hill, KS 66083 Phone: 913-592-2720 Fax: 913-592-2725 |