Ronald F Miciak, MD | |
801 Pole Line Rd W, Twin Falls, ID 83301-5810 | |
(208) 814-4100 | |
(208) 814-4908 |
Full Name | Ronald F Miciak |
---|---|
Gender | Male |
Speciality | Hospitalist |
Location | 801 Pole Line Rd W, Twin Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1235179052 | NPI | - | NPPES |
P00029390 | Other | ID | RR MEDICARE |
002543700 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | M4130 (Idaho) | Secondary |
208M00000X | Hospitalist | M4130 (Idaho) | Primary |
Entity Name | St Lukes Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
Mailing Address | Practice Location Address |
---|---|
Ronald F Miciak, MD Po Box 587, Twin Falls, ID 83303-0587 Ph: (208) 814-7400 | Ronald F Miciak, MD 801 Pole Line Rd W, Twin Falls, ID 83301-5810 Ph: (208) 814-4100 |
Kyle Wong, DO Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Dr. Sindy Kay Byington, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 406-927-6976 | |
Dr. Thomas Dirocco, M.D. Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-4100 |