| William Russell Farrell, MD | |
|
615 N Michigan St, South Bend, IN 46601-1033 | |
| (574) 647-7459 | |
| (574) 647-3658 |
| Full Name | William Russell Farrell |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 615 N Michigan St, South Bend, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417034968 | NPI | - | NPPES |
| 3037390 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 01041908A (Indiana) | Primary |
| Entity Name | South Bend Emergency Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487132114 PECOS PAC ID: 0941282354 Enrollment ID: O20181212000947 |
| Mailing Address | Practice Location Address |
|---|---|
| William Russell Farrell, MD 328 N Michigan St, Suite 200, South Bend, IN 46601-1244 Ph: (574) 647-1842 | William Russell Farrell, MD 615 N Michigan St, South Bend, IN 46601-1033 Ph: (574) 647-7459 |
Dr. Peter Ray Martin, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 715 Park Ave, South Bend, IN 46616 Phone: 574-536-4151 | |
Benjamin Glines I, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-1000 | |
Philip Richard Kavanagh, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-7459 Fax: 574-647-3658 | |
Cheryl Wibbens, MD, MBA Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-6525 Fax: 574-647-6691 | |
Dr. Aoko Doris Crain, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-7459 Fax: 574-647-3658 | |
James Devereaux, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 801 E Lasalle Ave, South Bend, IN 46617 Phone: 574-282-8902 | |
Thomas Sweeney, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-7459 Fax: 574-647-3658 |