| Kevin M Small, MD | |
|
621 Memorial Dr Ste 312, South Bend, IN 46601-1073 | |
| (574) 647-5200 | |
| (574) 647-5210 |
| Full Name | Kevin M Small |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 32 Years |
| Location | 621 Memorial Dr Ste 312, South Bend, 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 |
|---|---|---|---|
| 1689669715 | NPI | - | NPPES |
| 200181930 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0204X | Radiology - Vascular & Interventional Radiology | 01044597A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hospital Of South Bend | South bend, IN | Hospital |
| Elkhart General Hospital | Elkhart, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Radiology Inc | 5890695464 | 35 |
| Entity Name | Beacon Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033161617 PECOS PAC ID: 1254243306 Enrollment ID: O20031105000657 |
| Entity Name | Radiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578557815 PECOS PAC ID: 5890695464 Enrollment ID: O20040515000242 |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin M Small, MD 710 N Niles Ave, South Bend, IN 46617-1924 Ph: (574) 647-1610 | Kevin M Small, MD 621 Memorial Dr Ste 312, South Bend, IN 46601-1073 Ph: (574) 647-5200 |
Dr. Scott H Wolf, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 211 N Eddy St, South Bend, IN 46617 Phone: 574-237-9203 Fax: 574-237-9311 | |
Dr. Vu H Nguyen, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 121 S Saint Louis Blvd, South Bend, IN 46617 Phone: 574-233-3123 Fax: 574-233-3125 | |
Dr. Michael John Hall, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 100 Navarre Pl Ste 5500, South Bend, IN 46601 Phone: 574-647-5200 Fax: 574-647-5210 | |
Dr. Brett A Stephens, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 121 S Saint Louis Blvd, South Bend, IN 46617 Phone: 574-233-3123 Fax: 574-233-3125 | |
Dr. David A Cory, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 121 S Saint Louis Blvd, South Bend, IN 46617 Phone: 574-233-3123 Fax: 574-233-3125 | |
Brian Schirf, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 100 Navarre Pl, Ste 5500, South Bend, IN 46601 Phone: 574-647-5200 Fax: 574-647-5210 | |
Dr. Thomas A Bowers, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 211 N Eddy St, South Bend, IN 46617 Phone: 574-237-9203 Fax: 574-237-9311 |