Colt Kennington, | |
1906 Fairview Ave Ste 220, Caldwell, ID 83605-5432 | |
(208) 795-5072 | |
Not Available |
Full Name | Colt Kennington |
---|---|
Gender | Male |
Speciality | Psychiatry |
Experience | 5 Years |
Location | 1906 Fairview Ave Ste 220, Caldwell, 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 |
---|---|---|---|
1386106268 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | O-1812 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
West Valley Medical Center | Caldwell, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
West Valley Medical Group Llc | 8729180310 | 12 |
Entity Name | West Valley Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871673798 PECOS PAC ID: 8729180310 Enrollment ID: O20070228000567 |
Mailing Address | Practice Location Address |
---|---|
Colt Kennington, Po Box 277976, Atlanta, GA 30384-7976 Ph: () - | Colt Kennington, 1906 Fairview Ave Ste 220, Caldwell, ID 83605-5432 Ph: (208) 795-5072 |
Dr. Sandra Lare, D.O. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2609 S 10th Ave Ste 102, Caldwell, ID 83605 Phone: 208-454-2766 | |
Wade Harris, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St, Ste 201, Caldwell, ID 83605 Phone: 208-454-0567 | |
Dr. Richard A. Montgomery, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave Ste 220, Caldwell, ID 83605 Phone: 208-795-5072 | |
Dr. Alfred F Brem, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1906 Fairview Ave Ste 220, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-442-6520 | |
Dr. L. Mark Kimsey, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 305 E Logan St, Caldwell, ID 83605 Phone: 208-459-2840 Fax: 208-459-3012 | |
Lawrence Estel Banta, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave, Suite 200, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-442-6520 |