| Jon Edward Kretzler, MD | |
|
625 9th Ave, Ste 210, Longview, WA 98632-2465 | |
| (360) 501-3400 | |
| (360) 423-6862 |
| Full Name | Jon Edward Kretzler |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 625 9th Ave, Longview, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417922840 | NPI | - | NPPES |
| 1084128 | Medicaid | WA | |
| 057989 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | MD00030913 (Washington) | Primary |
| Entity Name | The Vancouver Clinic Inc Ps |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992759427 PECOS PAC ID: 3173436490 Enrollment ID: O20031111000793 |
| Entity Name | Longview Orthopedic Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003865072 PECOS PAC ID: 7315976792 Enrollment ID: O20050805000452 |
| Mailing Address | Practice Location Address |
|---|---|
| Jon Edward Kretzler, MD 625 9th Ave, Ste 210, Longview, WA 98632-2465 Ph: (360) 501-3400 | Jon Edward Kretzler, MD 625 9th Ave, Ste 210, Longview, WA 98632-2465 Ph: (360) 501-3400 |
Dr. Tony C Lin, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 625 9th Ave, Ste 210, Longview, WA 98632 Phone: 360-501-3400 Fax: 360-423-5682 | |
William Taylor Turner, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 625 9th Ave, Ste 210, Longview, WA 98632 Phone: 360-501-3400 Fax: 360-423-6862 | |
Dr. Peter Kung, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 625 9th Ave Ste 210, Longview, WA 98632 Phone: 360-501-3400 Fax: 360-423-6862 | |
David Michael Black, MD Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 625 9th Ave, Ste 210, Longview, WA 98632 Phone: 360-501-3400 Fax: 360-423-6862 | |
Anthony J Lauder, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 625 9th Ave Ste 210, Longview, WA 98632 Phone: 360-501-3400 Fax: 360-423-6862 | |
Tiffany C Liu, Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 625 9th Ave Ste 210, Longview, WA 98632 Phone: 415-476-6548 |