| Kimberly L Dillon, MD | |
| 
					442 W High St Ste 3, Bryan, OH 43506-1681  | |
| (419) 636-4517 | |
| (419) 636-6438 | 
| Full Name | Kimberly L Dillon | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 442 W High St Ste 3, Bryan, Ohio | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1376599043 | NPI | - | NPPES | 
| 2345993 | Medicaid | OH | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 35080816 (Ohio) | Primary | 
| Entity Name | Midwest Community Health Associates, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1619915170 PECOS PAC ID: 0941114250 Enrollment ID: O20031231000726  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kimberly L Dillon, MD 11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701 Ph: () -  | Kimberly L Dillon, MD 442 W High St Ste 3, Bryan, OH 43506-1681 Ph: (419) 636-4517  | 
Luvenia E. Tantoco, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 442 W High St, Bryan, OH 43506 Phone: 419-636-4517 Fax: 419-636-6438  | |
Hardev S Sroa, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 442 W High St Ste 3, Bryan, OH 43506 Phone: 419-636-4517 Fax: 419-636-6438  | |
Ms. Celeste D Lopez, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 442 W High St Ste 3, Bryan, OH 43506 Phone: 419-636-4517 Fax: 419-636-6438  |