| Idaho State University | |
|
650 Memorial Drive, # 68, Pocatello, ID 83209-0001 | |
| (208) 282-3495 | |
| (208) 282-4571 |
| Full Name | Idaho State University |
|---|---|
| Type | Facility |
| Speciality | Audiologist |
| Location | 650 Memorial Drive, Pocatello, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578508081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | AUD1225 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Idaho State University 650 Memorial Drive, # 68, Pocatello, ID 83209-0001 Ph: (208) 282-3495 | Idaho State University 650 Memorial Drive, # 68, Pocatello, ID 83209-0001 Ph: (208) 282-3495 |
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 | |
Dr. Mary M. Whitaker, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: 650 Memorial Drive, Bldg 68, Pocatello, ID 83209 Phone: 208-282-2190 | |
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 |