Jacob Sup, DO | |
2005 Arlington Ave, Caldwell, ID 83605-4808 | |
(208) 459-1025 | |
(208) 459-1080 |
Full Name | Jacob Sup |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 7 Years |
Location | 2005 Arlington Ave, Caldwell, 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 |
---|---|---|---|
1295266401 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | O-1402 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Community Health Clinics Inc | 4082527353 | 70 |
Entity Name | Community Health Clinics Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457309122 PECOS PAC ID: 4082527353 Enrollment ID: O20040130000055 |
Mailing Address | Practice Location Address |
---|---|
Jacob Sup, DO Po Box 9, Nampa, ID 83653-0009 Ph: (208) 467-4431 | Jacob Sup, DO 2005 Arlington Ave, Caldwell, ID 83605-4808 Ph: (208) 459-1025 |
Stacy Jane Lamers, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Zachary A Leckenby, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 | |
Megan A Schwehr, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 808 Cleveland Blvd, Caldwell, ID 83605 Phone: 208-459-1025 Fax: 208-466-5359 | |
Miss J'cinda J'nae Bitters, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-459-3372 | |
Jessica D Blancett, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 | |
Lindsay Kaye Orme, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 |