| Dr Michael Jason Walls, MD | |
|
2845 Chancellor Dr, Crestview Hills, KY 41017-3418 | |
| (859) 301-2663 | |
| (859) 817-7848 |
| Full Name | Dr Michael Jason Walls |
|---|---|
| Gender | Male |
| Speciality | Interventional Pain Management |
| Experience | 21 Years |
| Location | 2845 Chancellor Dr, Crestview Hills, Kentucky |
| 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 |
|---|---|---|---|
| 1083888325 | NPI | - | NPPES |
| 003031812 | Other | UNITED HEALTHCARE PROVIDER ID NUMBER | |
| 0295938 | Medicaid | OH | |
| 298418KYIP | Other | KY | AETNA BETTER HEALTH OF KENTUCKY PROVIDER ID NUMBER |
| 9318357 | Other | AETNA PIN | |
| 300012365 | Medicaid | IN | |
| CS1811400200 | Other | CARESOURCE ID | |
| 000001148521 | Other | ANTHEM ID | |
| 15725575 | Other | KY | WELLCARE OF KENTUCKY PROVIDER ID NUMBER |
| 7100086870 | Medicaid | KY | |
| P02011197 | Other | KY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 42678 (Kentucky) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Orthocincy Orthopaedics And Sports Medicine Psc | 3173500196 | 155 |
| Orthocincy Orthopaedics And Sports Medicine Psc | 3173500196 | 155 |
| Entity Name | Robert Klickovich |
|---|---|
| Entity Type | Practitioner - Anesthesiology |
| Entity Identifiers | NPI Number: 1649204306 PECOS PAC ID: 9931106879 Enrollment ID: I20080214000023 |
| Entity Name | Orthocincy Orthopaedics & Sports Medicine Psc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598714560 PECOS PAC ID: 3173500196 Enrollment ID: O20040707000498 |
| Entity Name | Commonwealth Pain Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306280177 PECOS PAC ID: 0941441919 Enrollment ID: O20130802000577 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Jason Walls, MD 560 S Loop Rd, Edgewood, KY 41017-3405 Ph: (859) 301-2663 | Dr Michael Jason Walls, MD 2845 Chancellor Dr, Crestview Hills, KY 41017-3418 Ph: (859) 301-2663 |
Philip L Zaacks, MD Pain Medicine Medicare: Not Enrolled in Medicare Practice Location: 350 Thomas More Pkwy, Suite 160, Crestview Hills, KY 41017 Phone: 513-221-1100 |