| Dr Michael Robert Wilcox, MD | |
|
310 1st Ave Nw, New Prague, MN 56071-1403 | |
| (952) 758-3090 | |
| (952) 758-8053 |
| Full Name | Dr Michael Robert Wilcox |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 310 1st Ave Nw, New Prague, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801814504 | NPI | - | NPPES |
| 420872200 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 20837 (Minnesota) | Secondary |
| 207Q00000X | Family Medicine | 20837 (Minnesota) | Primary |
| Entity Name | Ltc Professionals Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417251935 PECOS PAC ID: 7911181029 Enrollment ID: O20110414000668 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Robert Wilcox, MD 310 1st Ave Nw, New Prague, MN 56071-1403 Ph: (952) 758-3090 | Dr Michael Robert Wilcox, MD 310 1st Ave Nw, New Prague, MN 56071-1403 Ph: (952) 758-3090 |
Dr. Mark A Berg, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 1st St Ne, New Prague, MN 56071 Phone: 952-758-2535 Fax: 952-548-6160 | |
Dr. Michael Patrick O'rourke, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 1st St Ne, New Prague, MN 56071 Phone: 652-758-2535 Fax: 952-548-6160 | |
Kristin E. Tiegs, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 212 10th Ave Ne, New Prague, MN 56071 Phone: 952-758-4461 Fax: 952-758-5011 | |
Heather Hamernick, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 1st St Ne, New Prague, MN 56071 Phone: 952-758-2535 | |
Dr. John Howard Berg Jr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1400 1st St Ne, New Prague, MN 56071 Phone: 952-758-2535 Fax: 952-548-6160 | |
Dr. Steven J Kivi, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 301 Main St E, Suite 1, New Prague, MN 56071 Phone: 952-758-1050 Fax: 952-758-5011 | |
Dr. Daniel R Berg, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1400 1st St Ne, New Prague, MN 56071 Phone: 952-758-2535 Fax: 952-548-6160 |