Xakellis, George C

Xakellis, George C is an individual health care provider with primary practice located at 500 East Veteran Street , Tomah WI 54660-1016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Xakellis, George C can be contacted via phone (608) 372-1792.

Contact Information

Primary practice address
500 East Veteran Street Tomah WI 54660-1016
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD029031E Pennsylvania
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X MD029031E Pennsylvania

Profile Details

NPI number 1164418885
LBN Legal business name Xakellis, George C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Apr 3rd, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164418885 NPPES
Pennsylvania Other 1738142 HIGHMARK BLUE SHIELD
Pennsylvania Other 50047703 HIGHMARK BLUE SHIELD
Pennsylvania Other B18104 HIGHMARK BLUE SHIELD
Pennsylvania MEDICAID 1012794100001 HIGHMARK BLUE SHIELD

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