| Jordan Smith, | |
|
11040 N State Rd 77, Hayward, WI 54843 | |
| (715) 934-4910 | |
| (316) 665-6082 |
| Full Name | Jordan Smith |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 6 Years |
| Location | 11040 N State Rd 77, Hayward, Wisconsin |
| 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 |
|---|---|---|---|
| 1346866357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 82812-20 (Wisconsin) | Primary |
| 207QS0010X | Family Medicine - Sports Medicine | 82812-20 (Wisconsin) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Regional Hospice Services | Ashland, WI | Hospice |
| Tamarack Health Hayward Medical Center | Hayward, WI | Hospital |
| Hayward Health Services | Hayward, WI | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Medical Services, Inc | 9436061363 | 32 |
| Medical Services, Inc | 9436061363 | 32 |
| Advantage Physical Therapy And Sports Rehab, Llc | 8022016336 | 289 |
| Polinsky Medical Rehabilitation Center | 0941377360 | 369 |
| Entity Name | Medical Services, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912992827 PECOS PAC ID: 9436061363 Enrollment ID: O20040914001088 |
| Entity Name | Medical Services, Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1912992827 PECOS PAC ID: 9436061363 Enrollment ID: O20061104000208 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Smith, 11040 N State Rd 77, Hayward, WI 54843 Ph: (715) 934-4910 | Jordan Smith, 11040 N State Rd 77, Hayward, WI 54843 Ph: (715) 934-4910 |
Vicentiu Andrei, Family Medicine Medicare: Medicare Enrolled Practice Location: 11134 N Hwy 77, Hayward, WI 54843 Phone: 715-634-5505 |
Katherine Matthews Eichten, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 11040 N State Road 77, Hayward, WI 54843 Phone: 715-934-4321 |
Sabrina Ann Dunlap, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 11040 N State Rd 77, Hayward, WI 54843 Phone: 715-934-4910 Fax: 715-934-4620 |
Harry Douglas Malcolm, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 9940 N County Hwy K, Hayward, WI 54843 Phone: 715-638-5100 Fax: 715-634-6107 |
John Robert Mckevett, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 11134 N Hwy 77, Hayward, WI 54843 Phone: 715-634-5505 Fax: 715-634-5558 |
Dr. Mary Cord Mason, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 13380 W Trepania Rd, Hayward, WI 54843 Phone: 715-638-5101 Fax: 715-634-1021 |
Julie Beth Kahl, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 11134 N. State Rd 77, Duluth Clinic-hayward, Hayward, WI 54843 Phone: 715-634-5505 |