Larry Dean Harries, MD | |
307 St Johns Way, Ste 4, Lewiston, ID 83501 | |
(208) 743-8585 | |
(208) 743-0118 |
Full Name | Larry Dean Harries |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 307 St Johns Way, Lewiston, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033105994 | NPI | - | NPPES |
000226400 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | M3129 (Idaho) | Primary |
Entity Name | St Joseph Regional Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790816262 PECOS PAC ID: 2961497235 Enrollment ID: O20041220001093 |
Entity Name | St Joseph Hospital Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205368404 PECOS PAC ID: 8325325806 Enrollment ID: O20170606002496 |
Mailing Address | Practice Location Address |
---|---|
Larry Dean Harries, MD 307 St Johns Way, Ste 4, Lewiston, ID 83501 Ph: (208) 743-8585 | Larry Dean Harries, MD 307 St Johns Way, Ste 4, Lewiston, ID 83501 Ph: (208) 743-8585 |
Dr. Christina R Bjornstad, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 625 6th Ave, Lewiston, ID 83501 Phone: 208-743-8226 Fax: 208-746-2069 | |
Dr. Christine C Schaller, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-983-5120 Fax: 208-983-5404 | |
Dr. Donald J Greggain, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 415 6th St Ste 3c, Lewiston, ID 83501 Phone: 208-750-3840 Fax: 208-750-3839 | |
Glenn E Jefferson Jr., MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-746-1383 Fax: 208-746-6348 | |
Cheryl A Mallory, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-746-1383 Fax: 208-746-6348 | |
Celso R Chavez, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1522 17th St, Lewiston, ID 83501 Phone: 208-743-8416 Fax: 208-743-4642 |