| Dane W Jackson, MD | |
|
700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 | |
| (208) 625-6309 | |
| Not Available |
| Full Name | Dane W Jackson |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 700 W Ironwood Dr Ste 175, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952724361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | M-17814 (Idaho) | Primary |
| Entity Name | Riverside Radiology And Interventional Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093718496 PECOS PAC ID: 8729976964 Enrollment ID: O20191022002026 |
| Entity Name | Lucidsolutions Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518594480 PECOS PAC ID: 0749603462 Enrollment ID: O20210707003852 |
| Mailing Address | Practice Location Address |
|---|---|
| Dane W Jackson, MD 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 Ph: (208) 625-6309 | Dane W Jackson, MD 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 Ph: (208) 625-6309 |
Brian J Mcnamee, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr, Suite 110, Coeur D Alene, ID 83814 Phone: 208-666-3200 Fax: 208-666-3217 | |
Dr. Michael Gerardo Melendez, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 2789 E Spyglass Ct, Coeur D Alene, ID 83815 Phone: 208-610-0041 Fax: 208-777-1313 | |
Lauren Gayle Deur, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 250 Northwest Blvd, Suite #202, Coeur D Alene, ID 83814 Phone: 208-292-2263 Fax: 208-292-3130 | |
Dr. George F. Knight, M. D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 601 Front Avenue, Suite #502, Coeur D Alene, ID 83814 Phone: 208-415-0524 Fax: 208-763-3644 | |
Jeffrey Wayne Grossman, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2031 E Mountain Vista Dr, Coeur D Alene, ID 83815 Phone: 208-570-3342 | |
Dr. Bryan Douglas Berkey, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814 Phone: 208-625-3000 Fax: 208-625-6301 | |
Dr. Albert Jose Martinez, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814 Phone: 208-625-6309 Fax: 208-625-6310 |