Dan J Hendrickson, MD | |
401 E Hawaii, Nampa, ID 83686 | |
(208) 302-2100 | |
(208) 302-2125 |
Full Name | Dan J Hendrickson |
---|---|
Gender | Male |
Speciality | Internal Medicine - Pulmonary Disease |
Location | 401 E Hawaii, Nampa, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1467525949 | NPI | - | NPPES |
000010158154 | Other | ID | REGENCE |
807658900 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RP1001X | Internal Medicine - Pulmonary Disease | M-9672 (Idaho) | Primary |
207RC0200X | Internal Medicine - Critical Care Medicine | M-9672 (Idaho) | Secondary |
Entity Name | Saint Alphonsus Regional Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
Entity Name | Vibra Physicians Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659705424 PECOS PAC ID: 8921233933 Enrollment ID: O20141105002107 |
Mailing Address | Practice Location Address |
---|---|
Dan J Hendrickson, MD 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 302-2100 | Dan J Hendrickson, MD 401 E Hawaii, Nampa, ID 83686 Ph: (208) 302-2100 |
Wesley David Pidcock, DO Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2100 Fax: 208-302-2125 | |
Kenneth Wilhelm Jr., Pulmonary Disease Medicare: Not Enrolled in Medicare Practice Location: 4400 E Flamingo Ave, Nampa, ID 83687 Phone: 208-288-4970 Fax: 208-288-4990 | |
Michael M Dee, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-463-3234 Fax: 208-463-3044 | |
Justin Tomal, M.D. Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 1200 Garrity Blvd, Nampa, ID 83687 Phone: 208-343-6458 | |
Braden Lawrence, MD Pulmonary Disease Medicare: Medicare Enrolled Practice Location: 85 S Middleton Rd, Nampa, ID 83651 Phone: 208-381-4100 | |
Ryan J. Williams, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 900 N Happy Valley Rd, Nampa, ID 83687 Phone: 208-401-9639 | |
Nicholas W. Hodgman, MD Pulmonary Disease Medicare: Accepting Medicare Assignments Practice Location: 4424 E Flamingo Ave, Ste 300, Nampa, ID 83687 Phone: 208-302-0200 Fax: 208-302-0255 |