Ronald V Dorn Iii, MD | |
1055 N Curtis Road, Boise, ID 83706 | |
(208) 367-3131 | |
(208) 367-4860 |
Full Name | Ronald V Dorn Iii |
---|---|
Gender | Male |
Speciality | Radiology - Radiation Oncology |
Location | 1055 N Curtis Road, Boise, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780790279 | NPI | - | NPPES |
004085400 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0001X | Radiology - Radiation Oncology | M4653 (Idaho) | Primary |
Entity Name | St Lukes Clinic-treasure Valley Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
Mailing Address | Practice Location Address |
---|---|
Ronald V Dorn Iii, MD 3340 E Goldstone Way, Meridian, ID 83642 Ph: (208) 367-3131 | Ronald V Dorn Iii, MD 1055 N Curtis Road, Boise, ID 83706 Ph: (208) 367-3131 |
Dr. Micheal George Adondakis, MD Radiology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 Fax: 706-596-6720 | |
Jeffrey T Seabourn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2161 | |
Caroline D Sobota, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2161 | |
Mr. Jesse W Spinner, MD Radiology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 Fax: 706-596-6720 | |
Dr. Anna Willis Hudson, MD Radiology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-954-8070 Fax: 208-954-8073 | |
Brian Lane Mcmahan, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2094 Fax: 208-381-1791 | |
Craig E Leymaster, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2094 |