Dr Dale Justin Stormogipson, MD | |
1814 Lincoln Way, Coeur D Alene, ID 83814-2540 | |
(208) 667-2531 | |
(208) 765-9385 |
Full Name | Dr Dale Justin Stormogipson |
---|---|
Gender | Male |
Speciality | Ophthalmology |
Location | 1814 Lincoln Way, 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 |
---|---|---|---|
1336285345 | NPI | - | NPPES |
002694100 | Medicaid | ID | |
15180003516 | Other | NORTH IDAHO CATARACT & LA | |
000010006023 | Other | ID | REGENCE BLUE SHIELD OF ID |
DX761 | Other | ID | BLUE CROSS OF IDAHO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207W00000X | Ophthalmology | M5936 (Idaho) | Primary |
Entity Name | North Idaho Eye Institute P A |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699811646 PECOS PAC ID: 8820182736 Enrollment ID: O20070924000239 |
Mailing Address | Practice Location Address |
---|---|
Dr Dale Justin Stormogipson, MD 1814 Lincoln Way, Coeur D Alene, ID 83814-2540 Ph: (208) 667-2531 | Dr Dale Justin Stormogipson, MD 1814 Lincoln Way, Coeur D Alene, ID 83814-2540 Ph: (208) 667-2531 |
David Gerald Dance, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1814 Lincoln Way, Coeur D Alene, ID 83814 Phone: 208-667-2531 | |
Dr. David Anton Wold, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1814 Lincoln Way, Coeur D Alene, ID 83814 Phone: 208-667-2531 Fax: 208-765-9385 | |
Sara Duke, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 1814 Lincoln Way, Coeur D Alene, ID 83814 Phone: 208-667-2531 Fax: 208-665-5839 | |
Dr. Patrick John Parden, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1814 Lincoln Way, Coeur D Alene, ID 83814 Phone: 208-667-2531 Fax: 208-765-9385 | |
Dr. Stephen A Moss, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1814 Lincoln Way, Coeur D Alene, ID 83814 Phone: 208-667-2531 Fax: 208-765-9385 | |
Dr. Roderick Sidney Kent, M.D. Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1814 Lincoln Way, Coeur D Alene, ID 83814 Phone: 208-667-2531 Fax: 208-765-9385 |