| Floyd Joseph Fantelli, MD | |
|
3100 Channing Way, Idaho Falls, ID 83404-7533 | |
| (208) 529-6050 | |
| (208) 529-7085 |
| Full Name | Floyd Joseph Fantelli |
|---|---|
| Gender | Male |
| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
| Location | 3100 Channing Way, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831167113 | NPI | - | NPPES |
| 42168 | Other | ID | BLUE CROSS OF ID |
| 000010004040 | Other | ID | REGENCE BLUE SHIELD ID |
| 003697200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | M4216 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Floyd Joseph Fantelli, MD 1740 E 17th St, Ste D, Idaho Falls, ID 83404-6375 Ph: (208) 529-9779 | Floyd Joseph Fantelli, MD 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: (208) 529-6050 |
Gary Earl Ellwein, MD Pathology Medicare: Medicare Enrolled Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Matt Tannenbaum, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Clark R Daines, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Dr. Gabriele Emma Teermann, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6048 Fax: 208-529-7085 |