Kenneth Ryan, MD | |
651 Memorial Dr, Pocatello, ID 83201-4071 | |
(208) 239-1000 | |
Not Available |
Full Name | Kenneth Ryan |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 651 Memorial Dr, Pocatello, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003843343 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | M7235 (Idaho) | Primary |
Entity Name | Minidoka Memorial Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679553531 PECOS PAC ID: 7315908894 Enrollment ID: O20050801000086 |
Entity Name | Minidoka Memorial Hospital |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1679553531 PECOS PAC ID: 7315908894 Enrollment ID: O20061104000542 |
Mailing Address | Practice Location Address |
---|---|
Kenneth Ryan, MD 651 Memorial Dr, Pocatello, ID 83201-4071 Ph: (208) 239-1000 | Kenneth Ryan, MD 651 Memorial Dr, Pocatello, ID 83201-4071 Ph: (208) 239-1000 |
Randall Fowler, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 651 Memorial Dr, Pocatello, ID 83201 Phone: 208-239-1000 | |
Dr. Jordon Marshall, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way, Emergency Department, Pocatello, ID 83201 Phone: 208-239-1801 | |
Dr. Morgan Newel Anderson, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way, Pocatello, ID 83201 Phone: 208-239-1000 | |
Charles O Garrison, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1125 W Alameda Rd, Pocatello, ID 83201 Phone: 208-237-1151 Fax: 208-237-9721 | |
Dr. Andrew Lee Vincent, D.O. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way, Pocatello, ID 83201 Phone: 208-417-7569 Fax: 480-421-9899 | |
Nikola Charleen Radlach-barnack, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 921 S 8th Ave Stop 8253, Pocatello, ID 83209 Phone: 208-282-4726 |