Kenneth Andrew Widom (NPI# 1497706154, PAC ID# 6709851066) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GENERAL SURGERY.
| Nation Provider ID (NPI) | 1497706154 |
| PAC ID by PECOS | 6709851066 |
| Professional Enrollment ID | I20040831000052 |
| Full Name | Kenneth Andrew Widom |
| Organization Legal Name | GEISINGER CLINIC |
| Address |
100 N Academy Ave Danville PA 17822-9800 |
| Phone Number | 5702716541 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | GENERAL SURGERY |
| Group Practice PAC ID | 5395657001 |
| Number of Group Practice Members | 2590 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390006 | GEISINGER MEDICAL CENTER |
| 390013 | EVANGELICAL COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 100 N Academy Ave, Danville, PA 17822-9800 | 5702716541 | GEISINGER CLINIC |
| Organization Legal Name | GEISINGER CLINIC |
| Physicians | 2646 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ann Marie Elizabeth Trauger | Physical Therapy | Geisinger Clinic | 3 W Olive St, Scranton, PA 18508-2572 |
| Cassondra Andreychik Ellison | Dermatology | Geisinger Clinic | 16 Woodbine Lane, Geisinger Optometry, Danville, PA 17822-5240 |
| Catherine Patrick | Family Medicine | Geisinger Clinic | 1140 Quincy Ave, Dunmore, PA 18510-1150 |
| Rebecca Anne Phillips | Physician Assistant | Geisinger Clinic | 14229 Route 35, Richfield, PA 17086-8711 |
| Tiffany A Becker | Family Medicine | Geisinger Clinic | 560 Pierce St, Kingston, PA 18704-5716 |
| Boris Gilyadov | Family Medicine | Geisinger Clinic | 126 Market Way, Mt Pocono, PA 18344-1039 |
| Jui Pandya | Ophthalmology | Geisinger Clinic | 10 Trieble Dr, Tunkhannock, PA 18657-7054 |
| James Eric Kasenchak | Ophthalmology | Geisinger Clinic | 800 W 4th St, Suite 104, Williamsport, PA 17701-5895 |
| Cassandra Phillips | Pediatric Medicine | Geisinger Clinic | 529 Terry Reiley Way, Pottsville, PA 17901-1774 |
| Corrine Ann Joy | Nurse Practitioner | Geisinger Clinic | 1201 Keystone Blvd, Pottsville, PA 17901-8982 |
| Street Address |
100 N ACADEMY AVE |
| City | DANVILLE |
| State | PA |
| Zip | 17822-9800 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sue Ei | Psychologist, Clinical | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Joan Savage | Registered Dietitian Or Nutrition Professional | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Matthew C Cindric | Vascular Surgery | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Paul A Arkless | Critical Care (intensivists) | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Francis Lim | Hospitalist | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Roslyn Feaster | Certified Registered Nurse Anesthetist (crna) | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Lauren Scheeler | Physician Assistant | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Oded Goren | Neurosurgery | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Alicia Kathleen Edwards | Physician Assistant | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Utpal Jha | Internal Medicine | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Lee Troutman Jr. | Podiatry | Geisinger Clinic | 109 Woodbine Lane, Danville, PA 17822-0001 |
| Cassondra Andreychik Ellison | Dermatology | Geisinger Clinic | 16 Woodbine Lane, Geisinger Optometry, Danville, PA 17822-5240 |
| Ashley Pearce | Pediatric Medicine | Geisinger Clinic | 115 Woodbine Lane, Danville, PA 17822-9118 |
| Joel Michael Sumfest | Urology | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Mark S Rozick | Family Medicine | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Bernard J Gilligan | Certified Registered Nurse Anesthetist (crna) | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Christopher J Exner | Emergency Medicine | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Kimberly A Reed | Physician Assistant | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Steven R Bonebrake | Interventional Radiology | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Fitzgerald J Casimir | General Surgery | Geisinger Clinic | 100 N Academy Ave, Danville, PA 17822-9800 |
| Find all physicians in zip 17822 | |||
| City | DANVILLE |
| Zip Code | 17822 |
| Specialty | GENERAL SURGERY |
| City + Specialty | DANVILLE + GENERAL SURGERY |
Please comment or provide details below to improve the information on Kenneth Andrew Widom.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.