| Michael J Smith, MD | |
|
611 W Park St, Emergency Med., Urbana, IL 61801-2529 | |
| (217) 383-3313 | |
| (217) 383-4014 |
| Full Name | Michael J Smith |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine - Emergency Medical Services |
| Location | 611 W Park St, Urbana, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861491599 | NPI | - | NPPES |
| 000000517783 | Other | IN | ANTHEM |
| 200858510 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 01063120 (Indiana) | Secondary |
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 036141508 (Illinois) | Primary |
| Entity Name | Kirby Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386635373 PECOS PAC ID: 6901791144 Enrollment ID: O20050801000320 |
| Entity Name | Carle Health Care Incorporated |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154653947 PECOS PAC ID: 3577515774 Enrollment ID: O20100513000829 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael J Smith, MD 611 W Park St, Bwpc, Urbana, IL 61801-2529 Ph: (217) 383-6941 | Michael J Smith, MD 611 W Park St, Emergency Med., Urbana, IL 61801-2529 Ph: (217) 383-3313 |
Dr. Carlos Enrique Brown Jr., M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3313 | |
Dr. Imran Khan, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3313 Fax: 217-383-4014 | |
Dr. Brent Olson, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3313 Fax: 217-383-4014 | |
Brendan Mcevoy, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3285 | |
Michael F Hegarty, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 611 W. Park Street, Emergency Medicine, Urbana, IL 61801 Phone: 217-383-4930 Fax: 217-383-4014 | |
Ryan Paul Hurth, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 611 W Park St, Urbana, IL 61801 Phone: 217-383-3313 Fax: 217-383-4014 | |
Lars Grant, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1400 W Park St, Emergency Department, Urbana, IL 61801 Phone: 217-337-2131 |