| Mr Hisman H Percival, MD | |
|
1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 | |
| (719) 545-8240 | |
| (719) 545-4319 |
| Full Name | Mr Hisman H Percival |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 35 Years |
| Location | 1600 N Grand Ave, Pueblo, Colorado |
| 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 |
|---|---|---|---|
| 1457354763 | NPI | - | NPPES |
| 87458748 | Medicaid | CO | |
| CO306605 | Other | CO | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 48086 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Parkview Medical Center, Inc | Pueblo, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Parkview Ancillary Services Corporation | 4385722511 | 273 |
| Poudre Valley Medical Group Llc | 9638208549 | 1992 |
| Entity Name | Sangre De Cristo Surgical Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184645418 PECOS PAC ID: 8224927801 Enrollment ID: O20040311001470 |
| Entity Name | Parkview Ancillary Services Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982878765 PECOS PAC ID: 4385722511 Enrollment ID: O20080429000248 |
| Entity Name | Poudre Valley Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Hisman H Percival, MD 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 Ph: (719) 545-8240 | Mr Hisman H Percival, MD 1600 N Grand Ave, Suite 430, Pueblo, CO 81003-2700 Ph: (719) 545-8240 |
Dr. Paul Raymond Radway, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3506 San Jose Ct, Pueblo, CO 81005 Phone: 719-252-6467 | |
Pantelis Hadjizacharia, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1401 Court St, Pueblo, CO 81003 Phone: 719-562-2300 | |
Michael Lee King, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1600 N Grand Ave, Ste 510, Pueblo, CO 81003 Phone: 719-566-3535 Fax: 719-566-3565 | |
Dr. Gregory Dewayne Mcclain, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1020 Lakeview Ave, Pueblo, CO 81004 Phone: 719-557-3777 Fax: 719-557-3775 | |
Dr. Rina K. Shinn, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1600 W 24th St, Pueblo, CO 81003 Phone: 719-546-4947 | |
Priscilla Nobecourt, Surgery Medicare: Accepting Medicare Assignments Practice Location: 1600 N Grand Ave Ste 430, Pueblo, CO 81003 Phone: 719-545-8240 | |
Philip Charles Marin, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1304 N Grand Ave, Pueblo, CO 81003 Phone: 719-669-8487 Fax: 719-669-8488 |