| Kyle Goham, | |
|
W180n8085 Town Hall Rd, Dept Of Anesthesiology, Menomonee Falls, WI 53051-3518 | |
| (262) 257-5100 | |
| Not Available |
| Full Name | Kyle Goham |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology Assistant |
| Experience | 12 Years |
| Location | W180n8085 Town Hall Rd, Menomonee Falls, Wisconsin |
| 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 |
|---|---|---|---|
| 1942638325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367H00000X | Anesthesiologist Assistant | 006981 (Georgia) | Secondary |
| 367H00000X | Anesthesiologist Assistant | 7717 (Wisconsin) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Medical College Of Wisconsin Inc | 2668384371 | 1902 |
| Entity Name | The Medical College Of Wisconsin Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699720086 PECOS PAC ID: 2668384371 Enrollment ID: O20031120000259 |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Goham, W180n8085 Town Hall Rd, Dept Of Anesthesiology, Menomonee Falls, WI 53051-3518 Ph: (262) 257-5100 | Kyle Goham, W180n8085 Town Hall Rd, Dept Of Anesthesiology, Menomonee Falls, WI 53051-3518 Ph: (262) 257-5100 |
Ammar Haq, AA Anesthesiologist Assistant Medicare: Medicare Enrolled Practice Location: W180n8085 Town Hall Rd, Anesthesiology, Menomonee Falls, WI 53051 Phone: 262-257-5100 | |
Matt Jenkins, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-257-5100 Fax: 262-518-5052 | |
Ann-michael Holland, AA-C Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-257-5100 Fax: 262-518-5052 | |
Jesse Vitch, AA Anesthesiologist Assistant Medicare: May Accept Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Department Of Anesthesiology, Menomonee Falls, WI 53051 Phone: 262-257-5100 | |
David R Howard, AA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Department Of Anesthesiology, Menomonee Falls, WI 53051 Phone: 262-257-5100 | |
Sara Zemanovic, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-257-5100 Fax: 262-518-5052 | |
Martha Rocio Hernandez-krummel, CAA Anesthesiologist Assistant Medicare: Accepting Medicare Assignments Practice Location: W180n8085 Town Hall Rd, Menomonee Falls, WI 53051 Phone: 262-257-5100 Fax: 262-518-5052 |