Stephen C Johnson, DO | |
895 N 6th E, Mountain Home, ID 83647-2207 | |
(702) 453-3799 | |
(702) 453-5741 |
Full Name | Stephen C Johnson |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 895 N 6th E, Mountain Home, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1427041201 | NPI | - | NPPES |
000769100 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 0-41 (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 |
---|---|
Stephen C Johnson, DO Po Box 507, Mountain Home, ID 83647-0507 Ph: (702) 453-3799 | Stephen C Johnson, DO 895 N 6th E, Mountain Home, ID 83647-2207 Ph: (702) 453-3799 |
Scott Alan Baldridge, D.O. Family Medicine Medicare: Medicare Enrolled Practice Location: 365 Mckenna Dr, Mountain Home, ID 83647 Phone: 208-587-9703 | |
Katherine Gray, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 120 Desert Sage Way, Mountain Home, ID 83647 Phone: 208-875-3988 Fax: 208-587-3324 | |
Dr. Karl H. Olson, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Mckenna Dr, Mountain Home, ID 83647 Phone: 208-587-9703 Fax: 208-580-9812 | |
Dr. Dennis Dan Crossley, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Mckenna Dr, Mountain Home, ID 83647 Phone: 208-587-9703 Fax: 208-580-9812 | |
Timothy James Muhonen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Mckenna Dr, Mountain Home, ID 83647 Phone: 208-587-9703 | |
Dr. Richard Frederick Starkey, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 805 N 6th E, Mountain Home, ID 83647 Phone: 208-587-9736 Fax: 208-587-7905 |