Mr Ricky Dwayne Latham, MD | |
2001 Valenica Drive, Suite 201, Idaho Falls, ID 83404 | |
(208) 524-9400 | |
(208) 524-9401 |
Full Name | Mr Ricky Dwayne Latham |
---|---|
Gender | Male |
Speciality | Cardiovascular Disease (cardiology) |
Experience | 45 Years |
Location | 2001 Valenica Drive, Idaho Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477553139 | NPI | - | NPPES |
111489100 | Other | MEDICAID WYOMING, MWY | |
000010005099 | Other | BLUE SHIELD OF ID, BS | |
060053550 | Other | RAILROAD MEDICARE, RRM | |
DZ692 | Other | BLUE CROSS OF ID SE, BC2 | |
M6887 | Other | ID | ID |
000010005099 | Other | BLUE SHIELD OF ID S, BS2 | |
000353200 | Other | EDS- MEDICAID, EDS | |
111489100 | Other | WY/EDS CONSULTEC, INC WYM | |
8318842 | Other | MEDICAID OF WA, MD-W | |
DZ692 | Other | BLUE CROSS OF IDAHO, BC | |
000353200 | Medicaid | ID | |
500680039 | Medicaid | OR | |
0031512 | Other | MONTANA MEDICAID, MEM | |
1134041 | Other | MEDICARE-CIGNA, MC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | M6887 (Idaho) | Secondary |
207RC0000X | Internal Medicine - Cardiovascular Disease | MD170342 (Oregon) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Bingham Memorial Hospital | Blackfoot, ID | Hospital |
Eastern Idaho Regional Medical Center | Idaho falls, ID | Hospital |
Caribou Memorial Hospital | Soda springs, ID | Hospital |
Bear Lake Memorial Hospital | Montpelier, ID | Hospital |
Mountain View Hospital | Idaho falls, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Bmh Inc | 8426149758 | 124 |
Bmh Inc | 8426149758 | 124 |
Entity Name | Bay Area Hospital District |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225016561 PECOS PAC ID: 2163331000 Enrollment ID: O20040310000301 |
Mailing Address | Practice Location Address |
---|---|
Mr Ricky Dwayne Latham, MD 1775 Thompson Rd, Coos Bay, OR 97420-2125 Ph: (541) 266-4650 | Mr Ricky Dwayne Latham, MD 2001 Valenica Drive, Suite 201, Idaho Falls, ID 83404 Ph: (208) 524-9400 |
Dr. Douglas N Whatmore, M.D. Cardiovascular Disease Medicare: Medicare Enrolled Practice Location: 3200 Channing Way, Ste 205, Idaho Falls, ID 83404 Phone: 208-535-4300 Fax: 208-535-4315 | |
Blake Anderson, Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-227-2850 | |
Jordan Joseph Cormier, PA-C Cardiovascular Disease 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. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-227-2575 | |
Mr. Craig D Scoville, MD Cardiovascular Disease 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 Cardiovascular Disease 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. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2770 Cortez Ave, Idaho Falls, ID 83404 Phone: 208-522-4000 Fax: 208-528-4254 |