| Dr Maida E Colon, MD | |
|
727 Hospital Dr, Shelbyville, KY 40065-1660 | |
| (502) 647-4347 | |
| Not Available |
| Full Name | Dr Maida E Colon |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Location | 727 Hospital Dr, Shelbyville, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205831674 | NPI | - | NPPES |
| 000000275811 | Other | KY | BCBS 12 DIGIT PROVIDER # |
| 1069567 | Other | KY | PASSPORT GROUP # 1172544 |
| 50000550 | Other | KY | PASSPORT GROUP # 50000548 |
| 64247695 | Medicaid | KY | |
| 000000060164 | Other | KY | BCBS 12 DIGIT PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 24769 (Kentucky) | Primary |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050302000285 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Maida E Colon, MD Po Box 8, Louisville, KY 40201-0008 Ph: (800) 476-8646 | Dr Maida E Colon, MD 727 Hospital Dr, Shelbyville, KY 40065-1660 Ph: (502) 647-4347 |
Dr. Ray C Kennedy, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 727 Hospital Dr, Shelbyville, KY 40065 Phone: 502-647-4347 | |
Dr. Yolanda Shields, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 727 Hospital Dr, Shelbyville, KY 40065 Phone: 502-647-4347 | |
Justina Marie Ellis, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 515 Hospital Dr Ste 1, Shelbyville, KY 40065 Phone: 502-633-3525 | |
Frank J Martin, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 727 Hospital Dr, Shelbyville, KY 40065 Phone: 800-476-8646 Fax: 919-382-3210 | |
Dr. Donald W Payne, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 727 Hospital Dr, Shelbyville, KY 40065 Phone: 502-647-4347 | |
Brenden M Wetherton, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 727 Hospital Dr, Shelbyville, KY 40065 Phone: 502-647-4347 |