| Emma Gibson, | |
|
2424 S 90th St, West Allis, WI 53227-2455 | |
| (414) 328-8150 | |
| Not Available |
| Full Name | Emma Gibson |
|---|---|
| Gender | Female |
| Speciality | Surgery |
| Location | 2424 S 90th St, West Allis, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538690078 | NPI | - | NPPES |
| 100083087 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 70233 (Wisconsin) | Primary |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Entity Name | Lakeshore Medical Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
| Mailing Address | Practice Location Address |
|---|---|
| Emma Gibson, Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250 | Emma Gibson, 2424 S 90th St, West Allis, WI 53227-2455 Ph: (414) 328-8150 |
Dr. Simin Golestani, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 2424 S 90th St, West Allis, WI 53227 Phone: 414-328-8080 Fax: 414-328-8084 | |
Nicole M Zaremba, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 8905 W Lincoln Ave Ste 401, West Allis, WI 53227 Phone: 414-329-5627 | |
Seth E Smith, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2424 S 90th St Fl 3, West Allis, WI 53227 Phone: 414-328-8080 Fax: 414-328-8350 | |
Dr. Richard J Grieshop, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2424 S 90th St Ste 300, West Allis, WI 53227 Phone: 414-328-8150 | |
Mark R Wendling, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 6609 W Greenfield Ave, West Allis, WI 53214 Phone: 414-257-8500 | |
Dr. Frederick Joseph Steele, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 7220 W National Ave, West Allis, WI 53214 Phone: 414-257-8500 Fax: 414-257-8505 | |
Dr. John F Kispert, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2424 S 90th St Ste 300, West Allis, WI 53227 Phone: 414-328-8150 |