| Dr Thomas Milan Mirich Iii, MD | |
|
611 S Chestnut St, Suite D, Ellensburg, WA 98926-4815 | |
| (509) 933-8700 | |
| (509) 933-8705 |
| Full Name | Dr Thomas Milan Mirich Iii |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 611 S Chestnut St, Ellensburg, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952327025 | NPI | - | NPPES |
| 99366 | Other | MT | BLUE CROSS/BLUE SHIELD |
| P00465648 | Other | MEDICARE RR PTAN | |
| 1952327025 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 11582 (Montana) | Primary |
| Entity Name | Kittitas County Public Hospital Dist 1 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356375307 PECOS PAC ID: 0547179608 Enrollment ID: O20040213000046 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas Milan Mirich Iii, MD 611 S Chestnut St, Suite D, Ellensburg, WA 98926-4815 Ph: (509) 933-8700 | Dr Thomas Milan Mirich Iii, MD 611 S Chestnut St, Suite D, Ellensburg, WA 98926-4815 Ph: (509) 933-8700 |
Dr. William Roby Pace Iii, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 700 E Manitoba Ave, Suite 105, Ellensburg, WA 98926 Phone: 509-962-6500 Fax: 509-962-6011 | |
Gary D Bos, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 611 S Chestnut St, Ste. D, Ellensburg, WA 98926 Phone: 509-573-3989 Fax: 509-933-8705 | |
Ann Patricia Gorai, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 611 S Chestnut St Ste E, Ellensburg, WA 98926 Phone: 509-962-5437 |