| John C Maino Ii, MD | |
|
2200 Smalley St, Jackson, MI 49203-3725 | |
| (517) 740-9087 | |
| Not Available |
| Full Name | John C Maino Ii |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2200 Smalley St, Jackson, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902851173 | NPI | - | NPPES |
| 104144967 | Medicaid | MI | |
| 930095625 | Other | MI | RR MEDIACRE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 60303031 (Washington) | Secondary |
| 207P00000X | Emergency Medicine | 4301042724 (Michigan) | Primary |
| Entity Name | Independent Emergency Physicians Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780791343 PECOS PAC ID: 6709798325 Enrollment ID: O20031103000407 |
| Mailing Address | Practice Location Address |
|---|---|
| John C Maino Ii, MD 2200 Smalley St., Jackson, MI 49203-3726 Ph: (517) 740-9087 | John C Maino Ii, MD 2200 Smalley St, Jackson, MI 49203-3725 Ph: (517) 740-9087 |
Jonathan F. Bradley, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 Fax: 517-796-6410 | |
Ross Warren Kynast, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 Fax: 248-893-6952 | |
Kevin Killian, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-205-4800 | |
Deepa S Macha, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4996 Fax: 517-796-6410 | |
Dr. Gregory W Fuller, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1006 Airport Rd, Jackson, MI 49202 Phone: 517-784-6663 Fax: 517-787-7976 | |
Dr. Brett Mcknight Russell, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4800 | |
David Farhat, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 205 N East Ave, Jackson, MI 49201 Phone: 517-788-4996 Fax: 517-796-6410 |