Nicholas Blickenstaff, MD, MS | |
6454 W Emerald St, Boise, ID 83704-8734 | |
(208) 377-0820 | |
(208) 375-8046 |
Full Name | Nicholas Blickenstaff |
---|---|
Gender | Male |
Speciality | Dermatology |
Experience | 6 Years |
Location | 6454 W Emerald St, Boise, Idaho |
Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437544582 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207N00000X | Dermatology | 036.150002 (Illinois) | Secondary |
207N00000X | Dermatology | M15699 (Idaho) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Ada Dermatology, P.a. | 5395833586 | 4 |
Entity Name | Ada Dermatology, P.a. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1952483299 PECOS PAC ID: 5395833586 Enrollment ID: O20071126000177 |
Mailing Address | Practice Location Address |
---|---|
Nicholas Blickenstaff, MD, MS 7123 W Archer Ave, Chicago, IL 60638-2203 Ph: (708) 634-4602 | Nicholas Blickenstaff, MD, MS 6454 W Emerald St, Boise, ID 83704-8734 Ph: (208) 377-0820 |
Dr. James H Stewart, PHD, MD Dermatology Medicare: Medicare Enrolled Practice Location: 7733 W Emerald St, Boise, ID 83704 Phone: 208-376-3220 Fax: 208-322-7370 | |
Lindie K Borton, M.D Dermatology Medicare: Accepting Medicare Assignments Practice Location: 3811 N Garden Center Way, Boise, ID 83703 Phone: 208-287-5525 Fax: 208-287-5530 | |
Marnie R Ririe, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1636 Hadley Ave., Boise, ID 83709 Phone: 208-258-2078 Fax: 208-258-2079 | |
Dr. Joseph Patrick Fetzek, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 6111 W Overland Rd, Boise, ID 83709 Phone: 208-377-0450 | |
Mrs. Jhon R Hall, MD Dermatology Medicare: Medicare Enrolled Practice Location: 13176 W Persimmon Lane, Boise, ID 83713 Phone: 208-939-8640 Fax: 208-939-1892 | |
Dr. Richard Dale Blickenstaff, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 6454 W Emerald Street, Boise, ID 83704 Phone: 208-377-0820 | |
Dr. Leon William Nowierski, M.D. Dermatology Medicare: May Accept Medicare Assignments Practice Location: 100 Warm Springs Ave, Suite A, Boise, ID 83712 Phone: 208-343-5910 Fax: 208-384-8562 |