Johnathan Beau Liljenquist, DO | |
2442 E 25th St, Idaho Falls, ID 83404-7549 | |
(208) 522-7310 | |
Not Available |
Full Name | Johnathan Beau Liljenquist |
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Gender | Male |
Speciality | Internal Medicine |
Location | 2442 E 25th St, Idaho Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1558985408 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | O-1865 (Idaho) | Primary |
Entity Name | Mountain View Hospital Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343 |
Mailing Address | Practice Location Address |
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Johnathan Beau Liljenquist, DO 2442 E 25th St, Idaho Falls, ID 83404-7549 Ph: (208) 522-7310 | Johnathan Beau Liljenquist, DO 2442 E 25th St, Idaho Falls, ID 83404-7549 Ph: (208) 522-7310 |
Dr. Douglas N Whatmore, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 3200 Channing Way, Ste 205, Idaho Falls, ID 83404 Phone: 208-535-4300 Fax: 208-535-4315 | |
Blake Anderson, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-227-2850 | |
Jordan Joseph Cormier, PA-C Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2330 Desoto St, Idaho Falls, ID 83404 Phone: 208-552-4909 Fax: 208-522-6101 | |
Dr. Shawn D Speirs, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-227-2575 | |
Mr. Craig D Scoville, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2220 E 25th St, Idaho Falls, ID 83404 Phone: 208-542-9080 Fax: 208-542-9081 | |
Paul A Gerlach, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2985 Cortez Ave, Idaho Falls, ID 83404 Phone: 208-523-3373 Fax: 208-523-8746 | |
Dr. Ned R Warner, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2770 Cortez Ave, Idaho Falls, ID 83404 Phone: 208-522-4000 Fax: 208-528-4254 |