| Elizabeth Hart Sugden, MD | |
|
132 5th Ave W, Jerome, ID 83338-1825 | |
| (208) 324-5286 | |
| (208) 324-9815 |
| Full Name | Elizabeth Hart Sugden |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 132 5th Ave W, Jerome, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356485767 | NPI | - | NPPES |
| 820227163G013 | Other | ID | TRICARE |
| 000010001456 | Other | ID | BLUE SHIELD OF IDAHO |
| 080064467 | Other | ID | MEDICARE RAILROAD |
| 820227163B002 | Other | ID | TRICARE |
| 1120618 | Other | ID | STATE INSURANCE FUND |
| 54312 | Other | ID | BLUE CROSS OF IDAHO |
| 000010142921 | Other | ID | BLUE SHIELD OF IDAHO |
| 003943200 | Medicaid | ID | |
| 820227163B002 | Other | ID | TRI CARE |
| J8499 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M5431 (Idaho) | Primary |
| 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 |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Hart Sugden, MD Po Box 587, Twin Falls, ID 83303-0587 Ph: (208) 814-7400 | Elizabeth Hart Sugden, MD 132 5th Ave W, Jerome, ID 83338-1825 Ph: (208) 324-5286 |
Dr. James S Irwin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 132 5th Ave W, Suite 1, Jerome, ID 83338 Phone: 208-814-9800 Fax: 208-814-9833 | |
Michael J Keller, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W Ste 1, Jerome, ID 83338 Phone: 208-814-9800 | |
Alma Iyon Soud, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W Ste 1, Jerome, ID 83338 Phone: 208-814-9800 Fax: 208-933-9651 | |
Brian Lee Johnson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 709 N Lincoln Ave, Jerome, ID 83338 Phone: 208-324-4301 | |
Logan Anderson, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W Ste 1&2, Jerome, ID 83338 Phone: 208-814-9800 | |
Nelson S Browning, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W Ste 1, Jerome, ID 83338 Phone: 208-814-9800 |