| Kenneth A Son, MD | |
|
1348 S 18th St, Fernandina Beach, FL 32034-4785 | |
| (904) 227-2003 | |
| (904) 277-2006 |
| Full Name | Kenneth A Son |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 45 Years |
| Location | 1348 S 18th St, Fernandina Beach, Florida |
| 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 |
|---|---|---|---|
| 1417048331 | NPI | - | NPPES |
| 00748833A | Medicaid | GA | |
| TJ447 | Other | FL | MEDICARE HF |
| P01265088 | Other | FL | RAILROAD MEDICARE |
| 004787700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 043782 (Georgia) | Secondary |
| 208M00000X | Hospitalist | ME111180 (Florida) | Secondary |
| 208800000X | Urology | ME111180 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wellstar Spalding Regional Hospital | Griffin, GA | Hospital |
| Viera Hospital | Melbourne, FL | Hospital |
| Cape Canaveral Hospital | Cocoa beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Health First Medical Group Llc | 7416100672 | 596 |
| Entity Name | Columbus Ambulatory Healthcare Services, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790733244 PECOS PAC ID: 1355244385 Enrollment ID: O20040128000790 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Entity Name | Piedmont Specialty Hospital Billing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699290510 PECOS PAC ID: 4183986490 Enrollment ID: O20180327001180 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth A Son, MD Po Box 2421, Salt Lake City, UT 84110-2421 Ph: (904) 202-1034 | Kenneth A Son, MD 1348 S 18th St, Fernandina Beach, FL 32034-4785 Ph: (904) 227-2003 |
Blaine S. Kristo, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 1348 S 18th St Ste 230, Fernandina Beach, FL 32034 Phone: 904-277-2003 Fax: 904-376-3271 | |
Margeaux Jenee Dennis, DO Urology Medicare: Accepting Medicare Assignments Practice Location: 1348 S 18th St Ste 230, Fernandina Beach, FL 32034 Phone: 904-277-2003 Fax: 904-277-2006 |