Dr Mary M Whitaker, AUD | |
650 Memorial Drive, Bldg 68, Pocatello, ID 83209-0001 | |
(208) 282-2190 | |
Not Available |
Full Name | Dr Mary M Whitaker |
---|---|
Gender | Female |
Speciality | Audiologist |
Location | 650 Memorial Drive, Pocatello, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497782577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
231H00000X | Audiologist | AUD1193 (Idaho) | Primary |
Provider Name | Idaho State University |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1952474777 PECOS PAC ID: 4688683030 Enrollment ID: O20060412000292 |
Mailing Address | Practice Location Address |
---|---|
Dr Mary M Whitaker, AUD 1649 Glacier St, Pocatello, ID 83201-2261 Ph: (208) 282-2190 | Dr Mary M Whitaker, AUD 650 Memorial Drive, Bldg 68, Pocatello, ID 83209-0001 Ph: (208) 282-2190 |
Jeff E Brockett, ED.D Audiologist Medicare: Accepting Medicare Assignments Practice Location: 650 Memorial Dr Bldg 68, Pocatello, ID 83209 Phone: 208-282-2556 | |
Dr. Makenzi Gwinn, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way Ste 115, Pocatello, ID 83201 Phone: 208-239-1960 Fax: 208-478-0076 | |
Mr. Edward Gregory Smith, M.S., CCC-A Audiologist Medicare: Medicare Enrolled Practice Location: 921 S 8th Ave Stop 8116, Pocatello, ID 83209 Phone: 208-282-3495 Fax: 208-282-4571 | |
Dr. Jennifer Holst, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: Idaho State University, 921 S. 8th Stop 8116, Pocatello, ID 83209 Phone: 208-282-3747 | |
Lindsay Anne Tucker, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 650 Memorial Dr, Pocatello, ID 83209 Phone: 208-233-4339 | |
Dr. Alisa Vineyard, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: 2350 Via Caporatti Dr, Suite B, Pocatello, ID 83201 Phone: 208-237-5322 |