Brandon Hanley, | |
1906 Fairview Ave Ste 350, Caldwell, ID 83605-5425 | |
(208) 505-2101 | |
Not Available |
Full Name | Brandon Hanley |
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Gender | Male |
Speciality | Family Medicine |
Location | 1906 Fairview Ave Ste 350, Caldwell, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1629508288 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | O-1730 (Idaho) | Primary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
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Brandon Hanley, 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Brandon Hanley, 1906 Fairview Ave Ste 350, Caldwell, ID 83605-5425 Ph: (208) 505-2101 |
Stacy Jane Lamers, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Zachary A Leckenby, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 | |
Megan A Schwehr, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 808 Cleveland Blvd, Caldwell, ID 83605 Phone: 208-459-1025 Fax: 208-466-5359 | |
Miss J'cinda J'nae Bitters, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-459-3372 | |
Jessica D Blancett, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 | |
Lindsay Kaye Orme, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Jacob Sup, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2005 Arlington Ave, Caldwell, ID 83605 Phone: 208-459-1025 Fax: 208-459-1080 |