| Mrs Norma J Kreilein, MD | |
|
1402 Grand Ave, Washington, IN 47501-2122 | |
| (812) 254-7310 | |
| (812) 257-8602 |
| Full Name | Mrs Norma J Kreilein |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1402 Grand Ave, Washington, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851376388 | NPI | - | NPPES |
| 000000291248 | Other | BCBS | |
| 100270240C | Medicaid | IN | |
| 100110590A | Medicaid | IN | |
| 450494518101 | Other | IN | CARE SOURCE |
| 100270240A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 036149288 (Illinois) | Secondary |
| 208000000X | Pediatrics | 01037533 (Indiana) | Primary |
| Entity Name | Bonaventure Medical Foundation Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1588775647 PECOS PAC ID: 7517863178 Enrollment ID: O20031212000374 |
| Entity Name | Richland Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467492124 PECOS PAC ID: 3870565732 Enrollment ID: O20040811000131 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Norma J Kreilein, MD Po Box 760, Washington, IN 47501-0760 Ph: (812) 254-7310 | Mrs Norma J Kreilein, MD 1402 Grand Ave, Washington, IN 47501-2122 Ph: (812) 254-7310 |
Tanya De La Vergne, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1402 Grand Ave, Washington, IN 47501 Phone: 812-257-0383 Fax: 812-257-7072 | |
Kiran Burla, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1401 Memorial Ave Ste C, Washington, IN 47501 Phone: 812-254-2872 |