| Gregory J Mickunas, MD | |
|
90 Jackson Pike, Gallipolis, OH 45631-1560 | |
| (740) 446-5201 | |
| (740) 446-5761 |
| Full Name | Gregory J Mickunas |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 27 Years |
| Location | 90 Jackson Pike, Gallipolis, Ohio |
| 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 |
|---|---|---|---|
| 1225076458 | NPI | - | NPPES |
| 2183131 | Medicaid | OH | |
| 930106929 | Other | RR MEDICARE | |
| 000000185284 | Other | OH | UNISON MEDICAID # |
| 001714125 | Other | MOUNTAIN STATE BCBS | |
| 000000205913 | Other | ANTHEM BCBS | |
| 3002989000 | Medicaid | WV | |
| 310917085143 | Other | OH | OHIO MEDICAID CARESOURCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 21326 (West Virginia) | Secondary |
| 207P00000X | Emergency Medicine | H09359 (Ohio) | Secondary |
| 207P00000X | Emergency Medicine | 35.076915 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ohiohealth O'bleness Hospital | Athens, OH | Hospital |
| Marietta Memorial Hospital | Marietta, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Marietta Memorial Hospital | 8224928965 | 353 |
| Ohio Valley Physicians Inc | 8729032966 | 100 |
| Entity Name | Selby General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124073465 PECOS PAC ID: 9638087893 Enrollment ID: O20040108000165 |
| Entity Name | Marietta Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962106328 PECOS PAC ID: 8224928965 Enrollment ID: O20040317000973 |
| Entity Name | Emergency Professional Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093762353 PECOS PAC ID: 7214832435 Enrollment ID: O20040511000864 |
| Entity Name | Ohio Valley Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962433177 PECOS PAC ID: 8729032966 Enrollment ID: O20050422000921 |
| Entity Name | Ohio Emergency Professionals Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982983425 PECOS PAC ID: 0547433328 Enrollment ID: O20111024000785 |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory J Mickunas, MD 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5201 | Gregory J Mickunas, MD 90 Jackson Pike, Gallipolis, OH 45631-1560 Ph: (740) 446-5201 |
Joseph D. Crum, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5586 Fax: 740-446-5749 | |
Dr. Carlton Wayne Herald, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5533 Fax: 740-441-3318 | |
T. Wayne Munro, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5201 Fax: 740-446-5761 | |
Dr. Andrew Thomas Hughes, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5412 Fax: 740-446-5761 | |
Susheel S Kakde Sr., M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 100 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5000 | |
Dr. Philip C. Robbins, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 90 Jackson Pike, Gallipolis, OH 45631 Phone: 740-446-5890 Fax: 740-446-5532 |