Shannon Kathleen Lance, DO | |
600 N Robbins Rd Ste 302, Boise, ID 83702-4565 | |
(208) 706-5930 | |
(208) 706-5942 |
Full Name | Shannon Kathleen Lance |
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Gender | Female |
Speciality | Internal Medicine - Rheumatology |
Location | 600 N Robbins Rd Ste 302, 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 |
---|---|---|---|
1700382421 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RR0500X | Internal Medicine - Rheumatology | O-1817 (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 |
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Shannon Kathleen Lance, DO 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Shannon Kathleen Lance, DO 600 N Robbins Rd Ste 302, Boise, ID 83702-4565 Ph: (208) 706-5930 |
Dr. Jennifer A Hofstra, MD Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 757-446-8920 Fax: 757-446-5242 | |
Dr. James Robert Polk, MD Rheumatology Medicare: Not Enrolled in Medicare Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3104 | |
Dr. Michael Frederic Krug, M.D. Rheumatology Medicare: Medicare Enrolled Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-5015 Fax: 208-381-1873 | |
Derrel V Walker, M.D. Rheumatology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Road, Boise, ID 83706 Phone: 208-367-7350 Fax: 208-367-3951 | |
Dr. Janat E. O'donnell, MD Rheumatology Medicare: Medicare Enrolled Practice Location: 500 W. Fort St., # 111, Boise, ID 83702 Phone: 208-422-1325 Fax: 208-422-1319 | |
Carl L Durning, MD Rheumatology Medicare: Not Enrolled in Medicare Practice Location: 6094 W Emerald St, Boise, ID 83704 Phone: 208-367-6575 Fax: 208-367-6597 | |
Dr. Christopher J Goulet, M.D. Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 6259 W Emerald St, Boise, ID 83704 Phone: 208-489-1900 Fax: 208-375-5286 |