Active NPI 1982627188 Individual Practitioner Male Practitioner

Dr. Richard Jay Wilcon , MD

Internal Medicine • Moosup, CT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Richard Wilcon, MD is a certified Internal Medicine practicing in Moosup, CT. With approximately 37 years of clinical experience since graduating from Georgetown University School Of Medicine in 1989, Dr. Wilcon delivers high-quality medical care to the local community at 122 PLAINFIELD RD.

Dr. Wilcon is affiliated with Day Kimball Medical Group Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least, established patient outpatient office visit, initial hospital care with moderate level of medical decision making, if using time, at least. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

122 Plainfield Rd

Moosup, CT 063541632

Telephone 8605644062

Fax 8605644879

Associated Practice Facility / Clinic

🏢 Richard J. Wilcon Facility NPI 1114115003

Medicare Profile & Education

Medical School

Georgetown University School Of Medicine

Graduation Year

1989

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Moosup, CT

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

37 Yrs Matches City Avg

City Avg: 37.0 Yrs

State Avg: 30.4 Yrs

Regional Practice Density

1 Specialists

Practicing in Moosup, CT (2753 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

45.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Wilcon (37 Years) 37 Yrs

Moosup Specialty Average (37.0 Years) 37.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	168	31	$135.00	$76.65
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	163	98	$245.00	$132.71
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	163	45	$135.00	$76.51
99213 Established patient office or other outpatient visit, typically 15 minutes	160	99	$175.00	$93.89
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	96	88	$385.00	$176.06
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	53	52	$260.00	$130.82
G0008 Administration of influenza virus vaccine	44	42	$40.00	$33.90
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	39	28	$140.00	$80.24
90662 Influenza vaccine split virus, preservative free	37	35	$122.00	$81.02
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	27	24	$250.00	$136.53
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	26	25	$250.00	$136.60
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	14	12	$45.00	$24.62
81002 Urinalysis, manual test	13	12	$5.00	$3.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	195	54	$135.00	$79.06
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	174	102	$245.00	$134.59
99213 Established patient office or other outpatient visit, typically 15 minutes	170	105	$175.00	$95.27
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	109	24	$135.00	$79.05
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	70	69	$385.00	$183.17
G0008 Administration of influenza virus vaccine	60	58	$40.00	$32.50
90662 Influenza vaccine split virus, preservative free	48	48	$122.00	$71.93
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	41	41	$260.00	$137.50
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	30	26	$250.00	$141.17
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	16	16	$250.00	$141.17
99496 Transitional care management services for problem of high complexity	15	14	$445.00	$297.77
99306 Initial nursing facility visit, typically 45 minutes per day	14	13	$315.00	$192.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	251	61	$135.00	$72.88
99213 Established patient office or other outpatient visit, typically 15 minutes	195	110	$175.00	$98.22
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	174	28	$135.00	$72.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	144	88	$245.00	$134.46
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	74	73	$385.00	$208.56
G0008 Administration of influenza virus vaccine	57	56	$40.00	$32.00
90662 Influenza vaccine split virus, preservative free	54	53	$120.50	$68.36
0064A Adm sarscov2 50mcg/0.25mlbst	48	45	$40.00	$38.81
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	43	37	$250.00	$135.63
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	36	35	$260.00	$142.11
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	23	21	$175.00	$96.12
81002 Urinalysis, manual test	20	18	$5.00	$3.43
99219 Hospital observation care, typically 50 minutes	18	18	$260.00	$131.84
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	17	17	$250.00	$135.56
99496 Transitional care management services for problem of high complexity	16	14	$445.00	$300.68
93000 Routine ekg using at least 12 leads including interpretation and report	14	13	$50.00	$15.56
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	13	11	$175.00	$96.11
99306 Initial nursing facility visit, typically 45 minutes per day	12	12	$315.00	$174.53
99306 Initial nursing facility visit, typically 45 minutes per day	12	11	$315.00	$173.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	294	135	$174.51	$98.53
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	222	50	$135.00	$73.73
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	145	39	$85.00	$46.80
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	143	83	$244.51	$137.85
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	91	84	$384.07	$208.81
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	79	22	$135.00	$73.73
0064A Adm sarscov2 50mcg/0.25mlbst	75	75	$40.00	$40.00
G0008 Administration of influenza virus vaccine	59	59	$40.00	$18.53
90662 Influenza vaccine split virus, preservative free	49	49	$94.43	$65.26
0013A Adm sarscov2 100mcg/0.5ml3rd	41	41	$40.00	$40.00
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	37	15	$85.00	$46.75
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	36	21	$140.00	$74.68
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	32	32	$260.00	$144.12
0011A Adm sarscov2 100mcg/0.5ml1st	29	29	$40.00	$34.82
0012A Adm sarscov2 100mcg/0.5ml2nd	27	27	$40.00	$38.52
99219 Hospital observation care, typically 50 minutes	26	26	$260.00	$142.22
81002 Urinalysis, manual test	25	21	$5.00	$3.48
0003A Adm sarscov2 30mcg/0.3ml 3rd	23	23	$40.00	$40.00
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	22	17	$250.00	$137.81
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	18	15	$250.00	$137.81
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	18	13	$200.00	$109.49
93000 Routine ekg using at least 12 leads including interpretation and report	17	16	$50.00	$16.21
99220 Hospital observation care, typically 70 minutes	15	14	$355.00	$192.51
99221 Initial hospital inpatient care per day, typically 30 minutes	14	13	$195.00	$106.97
99318 Nursing facility annual assessment, typically 30 minutes	13	13	$185.00	$101.85
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$104.77	$61.46
99496 Transitional care management services for problem of high complexity	11	11	$445.00	$303.94
91306 Sarscov2 vac 50mcg/0.25ml im	11	11	$40.00	$0.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	282	137	$140.33	$80.74
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	219	43	$85.00	$47.77
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	183	50	$85.00	$47.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	121	77	$205.33	$117.27
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	89	82	$385.00	$218.39
G0008 Administration of influenza virus vaccine	75	72	$40.00	$18.30
90662 Influenza vaccine split virus, preservative free	63	61	$87.62	$60.69
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	63	35	$135.00	$74.73
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	61	32	$135.00	$74.91
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	55	50	$85.00	$47.95
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	49	33	$140.00	$77.70
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	30	30	$260.00	$143.86
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	25	22	$250.00	$140.01
99219 Hospital observation care, typically 50 minutes	24	23	$260.00	$146.54
99221 Initial hospital inpatient care per day, typically 30 minutes	24	22	$195.00	$110.21
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	22	22	$250.00	$140.11
81002 Urinalysis, manual test	21	16	$5.00	$3.45
99238 Hospital discharge day management, 30 minutes or less	21	21	$140.00	$78.60
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	15	12	$200.00	$111.85
99220 Hospital observation care, typically 70 minutes	14	14	$355.00	$200.14
G0009 Administration of pneumococcal vaccine	12	12	$40.00	$18.24
99306 Initial nursing facility visit, typically 45 minutes per day	12	11	$315.00	$180.76
99496 Transitional care management services for problem of high complexity	12	11	$445.00	$267.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	332	161	$140.00	$79.70
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	267	69	$135.00	$73.55
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	188	32	$135.27	$73.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	159	102	$205.00	$116.75
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	99	95	$385.00	$215.55
G0008 Administration of influenza virus vaccine	89	85	$40.00	$17.96
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	81	59	$140.00	$77.54
90662 Influenza vaccine split virus, preservative free	73	70	$79.92	$54.68
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	72	67	$260.00	$146.10
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	36	34	$250.00	$139.13
99306 Initial nursing facility visit, typically 45 minutes per day	32	28	$315.00	$173.07
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	28	25	$200.00	$110.72
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	27	17	$65.00	$24.95
99219 Hospital observation care, typically 50 minutes	25	25	$260.00	$144.86
99496 Transitional care management services for problem of high complexity	22	18	$445.00	$250.36
81002 Urinalysis, manual test	21	17	$5.00	$3.41
99238 Hospital discharge day management, 30 minutes or less	21	21	$140.00	$78.27
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	20	18	$250.00	$139.10
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	20	19	$175.00	$93.87
99318 Nursing facility annual assessment, typically 30 minutes	17	17	$185.00	$102.41
99220 Hospital observation care, typically 70 minutes	16	16	$355.00	$185.34
93000 Routine ekg using at least 12 leads including interpretation and report	15	14	$50.00	$18.66
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	15	14	$28.87	$18.65
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$202.50	$108.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	454	94	$130.69	$74.00
99213 Established patient office or other outpatient visit, typically 15 minutes	314	166	$140.00	$78.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	194	126	$205.00	$114.20
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	136	128	$381.32	$213.57
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	107	92	$250.00	$138.68
G0008 Administration of influenza virus vaccine	85	82	$40.00	$22.26
90662 Influenza vaccine split virus, preservative free	75	72	$75.64	$51.96
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	69	68	$260.00	$143.03
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	68	48	$140.00	$74.50
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	55	39	$170.64	$97.76
81002 Urinalysis, manual test	46	40	$5.00	$3.41
99306 Initial nursing facility visit, typically 45 minutes per day	38	32	$315.00	$177.02
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	36	20	$135.00	$73.87
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	36	16	$85.00	$47.58
99219 Hospital observation care, typically 50 minutes	29	29	$260.00	$144.41
99220 Hospital observation care, typically 70 minutes	27	27	$351.48	$197.47
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	25	21	$200.00	$110.46
G0009 Administration of pneumococcal vaccine	25	25	$40.00	$22.26
99496 Transitional care management services for problem of high complexity	24	19	$440.83	$249.99
99495 Transitional care management services for problem of at least moderate complexity	22	19	$315.00	$176.63
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	21	13	$65.00	$23.52
99318 Nursing facility annual assessment, typically 30 minutes	21	21	$180.48	$102.35
99238 Hospital discharge day management, 30 minutes or less	21	21	$136.90	$77.90
99221 Initial hospital inpatient care per day, typically 30 minutes	19	18	$190.79	$107.92
90670 Pneumococcal vaccine for injection into muscle	19	19	$212.89	$190.14
93000 Routine ekg using at least 12 leads including interpretation and report	17	16	$50.00	$18.52
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	16	14	$105.00	$57.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	470	106	$133.00	$73.56
99213 Established patient office or other outpatient visit, typically 15 minutes	361	194	$142.66	$77.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	177	127	$208.53	$112.03
99223 Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	124	120	$378.87	$213.46
G0008 Administration of influenza virus vaccine	113	112	$39.95	$27.77
90662 Influenza vaccine split virus, preservative free	99	99	$62.70	$47.93
99305 Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes	71	62	$253.10	$138.06
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	69	68	$267.61	$143.39
99306 Initial nursing facility visit, typically 45 minutes per day	61	51	$319.57	$176.49
99309 Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	54	39	$173.00	$97.08
81002 Urinalysis, manual test	53	50	$5.28	$3.43
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	47	21	$85.70	$47.46
99219 Hospital observation care, typically 50 minutes	42	42	$257.38	$143.94
G0009 Administration of pneumococcal vaccine	42	42	$39.71	$27.77
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	35	29	$140.00	$76.26
90670 Pneumococcal vaccine for injection into muscle	35	35	$195.14	$174.00
99220 Hospital observation care, typically 70 minutes	29	29	$347.83	$196.55
99496 Transitional care management services for problem of high complexity	26	22	$434.69	$247.92
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	25	17	$67.80	$21.98
99495 Transitional care management services for problem of at least moderate complexity	25	25	$305.40	$175.54
99233 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	24	22	$204.17	$107.22
93000 Routine ekg using at least 12 leads including interpretation and report	19	16	$50.63	$18.48
99238 Hospital discharge day management, 30 minutes or less	17	17	$135.35	$73.80
99318 Nursing facility annual assessment, typically 30 minutes	16	16	$181.50	$102.42
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	14	14	$25.00	$17.32
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	13	13	$105.00	$58.03
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	12	12	$277.75	$154.71

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License CT 032260

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

001322601 (CT)

Commercial Insurance / Payer ID Cigna Health Plans

01032260

Commercial Insurance / Payer ID Railroad Medicare

110093870

Commercial Insurance / Payer ID Oxford Health Plans

P367719

Commercial Insurance / Payer ID Connecticare

705139

Commercial Insurance / Payer ID Anthem Bc/bs

010032260CT01

Commercial Insurance / Payer ID Health Net

030486

Hospital & Practice Group Affiliations

Day Kimball Medical Group Inc

320 Pomfret St, Putnam, CT 062601836

Phone: 8609286541

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Dana Cavicke , MD

Family Medicine

NPI 1639180607

Doctor of Medicine (M.D.)

Dr. Leilani Nixon , MD

Internal Medicine

NPI 1861577587

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active October 26, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location October 26, 2007

Registered at 122 PLAINFIELD RD, MOOSUP, CT 063541632 (Tel: 8605644062)

📍

Updated Business Mailing Address October 26, 2007

Registered at 122 PLAINFIELD RD, MOOSUP, CT 063541632 (Tel: 8605644062)

👤

Provider Name / Credentials Updated October 26, 2007

Recorded as RICHARD WILCON, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) October 26, 2007

Internal Medicine (License #032260 in CT)

🟢

Initial NPI Registration & Enumeration July 26, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Dr. Richard Wilcon. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1982627188

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 26, 2006

Last Update: October 26, 2007

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

122 Plainfield Rd

Moosup, CT 063541632

Phone: 8605644062

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.