| Keith Ennis, MD | |
|
1907 W Sycamore St, Kokomo, IN 46901-5148 | |
| (765) 456-5433 | |
| Not Available |
| Full Name | Keith Ennis |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 34 Years |
| Location | 1907 W Sycamore St, Kokomo, Indiana |
| 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 |
|---|---|---|---|
| 1033292628 | NPI | - | NPPES |
| 200014450E | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01040472A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension St Vincent Kokomo | Kokomo, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Vincent Physician Services Hospital And Health Care Center | 9638072184 | 252 |
| Entity Name | St Vincent Physician Services Hospital And Health Care Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669422234 PECOS PAC ID: 9638072184 Enrollment ID: O20040223001092 |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Ennis, MD 1907 W Sycamore St, Kokomo, IN 46901-5148 Ph: () - | Keith Ennis, MD 1907 W Sycamore St, Kokomo, IN 46901-5148 Ph: (765) 456-5433 |
Dr. Eric Tuchscherer, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1907 W Sycamore St, Kokomo, IN 46901 Phone: 765-456-5433 | |
Kevin Wineinger, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3118 S Lafountain St, Kokomo, IN 46902 Phone: 765-864-4160 Fax: 765-400-4467 | |
Dr. David Alan Cheesman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1907 W Sycamore St, Kokomo, IN 46901 Phone: 765-456-5433 | |
William Mohr, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2330 S Dixon Rd, Kokomo, IN 46902 Phone: 765-455-5400 Fax: 765-865-3912 | |
Emily A Backer, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 408 E Southway Blvd, Kokomo, IN 46902 Phone: 765-865-3300 Fax: 765-865-3306 | |
Dr. Rose Paul, Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 138 N Dixon Rd, Kokomo, IN 46901 Phone: 765-236-8282 |