| Kevin J Kriesel, MD | |
|
826 Washington St Fl 3, Watertown, NY 13601-4064 | |
| (315) 788-1751 | |
| (315) 788-9021 |
| Full Name | Kevin J Kriesel |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 826 Washington St Fl 3, Watertown, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720093883 | NPI | - | NPPES |
| 151036403 | Medicaid | TX | |
| 040017071 | Medicaid | TX | |
| 151036401 | Medicaid | TX | |
| 151036402 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | MD457864 (Pennsylvania) | Secondary |
| 207Y00000X | Otolaryngology | 329201 (New York) | Primary |
| 207Y00000X | Otolaryngology | L3721 (Texas) | Secondary |
| Entity Name | Samaritan Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598713745 PECOS PAC ID: 8123914876 Enrollment ID: O20040227000525 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin J Kriesel, MD 826 Washington St Fl 3, Watertown, NY 13601-4064 Ph: (315) 788-1751 | Kevin J Kriesel, MD 826 Washington St Fl 3, Watertown, NY 13601-4064 Ph: (315) 788-1751 |
Braxton L Hillerman, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 826 Washington St, Suite 204, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
Norman Weir, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 826 Washington St, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
William I Forbes Iii, MD PHD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 826 Washington St, Suite 204, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
David Christopher Gordon, PH.D., M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 830 Washington St, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
Tony C.y. Chuang, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 830 Washington St, Watertown, NY 13601 Phone: 315-788-1751 Fax: 315-788-9021 | |
Dr. Albert A. Mcclain Jr., M. D. Otolaryngology Medicare: May Accept Medicare Assignments Practice Location: 830 Washington St, Watertown, NY 13601 Phone: 315-786-4824 Fax: 315-786-4915 |