Mr Preston S Omer, MD | |
1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 | |
(208) 302-6800 | |
(208) 302-6855 |
Full Name | Mr Preston S Omer |
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Gender | Male |
Speciality | Pediatrics |
Location | 1510 12th Ave Rd Ste 200, Nampa, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831304526 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | M-11679 (Idaho) | Secondary |
208000000X | Pediatrics | 24019 (Nebraska) | Primary |
Entity Name | Saint Alphonsus Regional Medical Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
Entity Name | Southern Idaho Health Partners Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952701401 PECOS PAC ID: 5395063564 Enrollment ID: O20150420000863 |
Mailing Address | Practice Location Address |
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Mr Preston S Omer, MD Po Box 190930, Boise, ID 83719-0930 Ph: (208) 367-5170 | Mr Preston S Omer, MD 1510 12th Ave Rd Ste 200, Nampa, ID 83686-6008 Ph: (208) 302-6800 |
Thomas J Hammer, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1209 N Jacob Allcott Way, Nampa, ID 83687 Phone: 208-461-8700 Fax: 208-461-8705 | |
Dr. Brian S Liddell, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 9850 W St Lukes Dr Ste 270, Nampa, ID 83687 Phone: 208-205-7820 | |
Dr. Joseph Gregory Wilbanks, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 9850 W St Lukes Dr Ste 270, Nampa, ID 83687 Phone: 208-205-7820 Fax: 208-205-7822 | |
Mrs. Jeannette E Jain, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-468-5930 Fax: 208-463-3044 | |
Joseph L Papiez, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-468-5930 Fax: 208-463-3044 | |
Dr. Amanda King Mason, M.D., PH.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-463-3000 Fax: 208-463-3351 | |
Michael B Aldous, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1510 12th Ave Rd Ste 200, Nampa, ID 83686 Phone: 208-302-6800 Fax: 208-302-6855 |