| Michael R Wild, MD | |
|
3433 S Lafountain St, Kokomo, IN 46902-3801 | |
| (765) 453-3777 | |
| (765) 453-6577 |
| Full Name | Michael R Wild |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 32 Years |
| Location | 3433 S Lafountain St, Kokomo, 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 |
|---|---|---|---|
| 1437110541 | NPI | - | NPPES |
| 200126150 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | 01046415A (Indiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Memorial Hospital | Logansport, IN | Hospital |
| Riverview Health | Noblesville, IN | Hospital |
| Community Howard Regional Health Inc. | Kokomo, IN | Hospital |
| Ascension St Vincent Kokomo | Kokomo, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Eye Physicians Inc | 4385684711 | 3 |
| Entity Name | Eye Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669559761 PECOS PAC ID: 4385684711 Enrollment ID: O20050505000278 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Wild, MD 3433 S Lafountain St, Kokomo, IN 46902-3801 Ph: (765) 453-3777 | Michael R Wild, MD 3433 S Lafountain St, Kokomo, IN 46902-3801 Ph: (765) 453-3777 |
Alan Richard Crebo, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1601 W Lincoln Rd, Kokomo, IN 46902 Phone: 765-453-5696 Fax: 765-455-4323 | |
Robert B Dinn, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 3433 S Lafountain St, Kokomo, IN 46902 Phone: 765-453-3777 Fax: 765-453-6577 | |
Dr. Kuumba K Long, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1601 W Lincoln Rd, Kokomo, IN 46902 Phone: 765-453-5696 Fax: 765-455-4323 | |
Dr. Leo Gene Watson, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 5606 Four Mile Dr, Kokomo, IN 46901 Phone: 765-452-7000 |