Dr Kylan D Peterson, DO | |
730 N College Rd, Suite B, Twin Falls, ID 83301-3382 | |
(208) 814-7350 | |
(208) 732-8508 |
Full Name | Dr Kylan D Peterson |
---|---|
Gender | Male |
Speciality | Otolaryngology |
Experience | 16 Years |
Location | 730 N College Rd, Twin 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 |
---|---|---|---|
1750542452 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | O0713 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Gem State Ent Pllc | 8123470481 | 6 |
Entity Name | St Lukes Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
Entity Name | Gem State Ent Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215715669 PECOS PAC ID: 8123470481 Enrollment ID: O20240123000730 |
Mailing Address | Practice Location Address |
---|---|
Dr Kylan D Peterson, DO Po Box 587, Twin Falls, ID 83303-0587 Ph: (208) 814-7400 | Dr Kylan D Peterson, DO 730 N College Rd, Suite B, Twin Falls, ID 83301-3382 Ph: (208) 814-7350 |
Dr. Julian O Nicholson, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 730 N College Rd, Suite B, Twin Falls, ID 83301 Phone: 208-814-7350 Fax: 208-732-8508 | |
Dr. Russell Weldon Mayes, D.O. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 730 N College Rd, Suite B, Twin Falls, ID 83301 Phone: 208-814-7350 Fax: 208-732-8508 | |
Mr. Benjamin H Feldman, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 625 Pole Line Rd W Ste 2b, Twin Falls, ID 83301 Phone: 208-814-7350 Fax: 208-732-8508 |