Clark R Daines, MD | |
3100 Channing Way, Idaho Falls, ID 83404-7533 | |
(208) 529-6050 | |
(208) 529-7085 |
Full Name | Clark R Daines |
---|---|
Gender | Male |
Speciality | |
Experience | Years |
Location | 3100 Channing Way, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1144264045 | NPI | - | NPPES |
M11914 | Other | ID | STATE LICENSE |
79892 | Other | ID | BLUE CROSS IDAHO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | M11914 (Idaho) | Primary |
Mailing Address | Practice Location Address |
---|---|
Clark R Daines, MD 1820 E 17th St, Ste 230, Idaho Falls, ID 83404-6469 Ph: (208) 529-9779 | Clark R Daines, MD 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: (208) 529-6050 |
Gary Earl Ellwein, MD Pathology Medicare: Medicare Enrolled Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Matt Tannenbaum, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Floyd Joseph Fantelli, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Dr. Gabriele Emma Teermann, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6048 Fax: 208-529-7085 |