Mark Thibert, | |
929 Sw Simpson Ave, Suite 300, Bend, OR 97702-3599 | |
(541) 389-7741 | |
(541) 278-8376 |
Full Name | Mark Thibert |
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Gender | Male |
Speciality | Family Medicine |
Location | 929 Sw Simpson Ave, Bend, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225104235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 5190415-1205 (Utah) | Secondary |
207Q00000X | Family Medicine | MD00048052 (Washington) | Secondary |
207Q00000X | Family Medicine | MD169232 (Oregon) | Primary |
Entity Name | Mosaic Community Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083633184 PECOS PAC ID: 5395653497 Enrollment ID: O20040528001371 |
Mailing Address | Practice Location Address |
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Mark Thibert, Po Box 670, Bend, OR 97709-0670 Ph: (541) 389-7741 | Mark Thibert, 929 Sw Simpson Ave, Suite 300, Bend, OR 97702-3599 Ph: (541) 389-7741 |
Wendy Yerington Dryden, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2577 Ne Courtney Dr Ste 100, Bend, OR 97701 Phone: 541-383-3005 Fax: 541-383-1883 | |
Lisa Kristine Mizeur, FNP Family Medicine Medicare: Medicare Enrolled Practice Location: 2600 Ne Neff Rd, Bend, OR 97701 Phone: 541-706-4800 Fax: 541-706-4806 | |
William B Wignall, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1247 Ne Medical Center Dr, Bend, OR 97701 Phone: 541-318-4249 | |
Edward M Tarbet, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1501 Ne Medical Center Dr, Bend, OR 97701 Phone: 541-382-2811 Fax: 541-317-4588 | |
Michael R. Hudson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2600 Ne Neff Rd, Bend, OR 97701 Phone: 541-706-3700 Fax: 541-706-3730 | |
Dr. Michelle Ann Kyriakos, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 1375 Nw Kingston Ave, Bend, OR 97701 Phone: 541-383-5958 Fax: 541-383-3016 | |
Ryan Daniel Lurtsema, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1501 Ne Medical Center Dr, Bend, OR 97701 Phone: 541-382-4900 |