| Dr Will Innocent, MD | |
|
1600 N Main Ave, Lovington, NM 88260-2813 | |
| (575) 396-6611 | |
| (575) 396-1454 |
| Full Name | Dr Will Innocent |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1600 N Main Ave, Lovington, New Mexico |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659471555 | NPI | - | NPPES |
| 849713 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD2023-1670 (New Mexico) | Primary |
| 207Q00000X | Family Medicine | ME92937 (Florida) | Secondary |
| 207Q00000X | Family Medicine | 32113 (Arizona) | Secondary |
| Entity Name | Kids Kare Pediatrics Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508829326 PECOS PAC ID: 1658595806 Enrollment ID: O20140610001454 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Will Innocent, MD 1600 N Main Ave, Lovington, NM 88260-2813 Ph: (575) 396-6611 | Dr Will Innocent, MD 1600 N Main Ave, Lovington, NM 88260-2813 Ph: (575) 396-6611 |
Patrick J Homer, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 North Main, Lovington, NM 88260 Phone: 575-396-6611 Fax: 575-396-1454 | |
Cyril M Simon, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 N Main Ave, Lovington, NM 88260 Phone: 575-396-6611 Fax: 575-396-1454 | |
Neil M Berry, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 1600 North Main, Lovington, NM 88260 Phone: 575-396-6611 Fax: 575-396-1454 | |
Ariel Joy Scott, Family Medicine Medicare: Medicare Enrolled Practice Location: 1600 N Main Ave, Lovington, NM 88260 Phone: 575-396-6611 Fax: 575-396-1454 | |
Marco Maldonado, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 N Main Ave, Lovington, NM 88260 Phone: 575-396-6611 | |
Nageena Potluri, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 N Main Ave, Lovington, NM 88260 Phone: 575-396-6611 | |
Dr. Michael R Springer, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1600 North Main, Lovington, NM 88260 Phone: 575-396-6611 Fax: 575-396-1454 |