| Kourt Bacon, DO | |
| 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001 | |
| (971) 732-3174 | |
| Not Available | 
| Full Name | Kourt Bacon | 
|---|---|
| Gender | Male | 
| Speciality | Anesthesiology | 
| Location | 1 Jarrett White Rd, Tripler Army Medical Center, Hawaii | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1710449012 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207L00000X | Anesthesiology | 0102206358 (Virginia) | Primary | 
| Entity Name | Straub Clinic & Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1457306508 PECOS PAC ID: 6305759754 Enrollment ID: O20031111000417 | 
| Entity Name | Island Medical Consultants, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1881965986 PECOS PAC ID: 2264696681 Enrollment ID: O20120615000375 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kourt Bacon, DO 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001 Ph: () - | Kourt Bacon, DO 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859-5001 Ph: (971) 732-3174 | 
| Dr. Charles Dean Poppell, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Jarrett White Rd, Department Of Surgery/anesthesia, Tripler Army Medical Center, HI 96859 Phone: 808-433-5007 | |
| Dr. Kenneth Lee Gowdy, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859 Phone: 808-433-6661 | |
| Zachary Cyrus Affrin, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1 Jarrett White Rd Dept Of, Tripler Army Medical Center, HI 96859 Phone: 208-333-0845 | |
| Dr. Karen Graf Galloway, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859 Phone: 808-433-5447 | |
| William Charles Fox, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859 Phone: 877-997-5403 | |
| Michael Williams,  Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859 Phone: 808-433-4525 |