Sulabha Chaganaboyana, MD | |
465 Memorial Dr, Pocatello, ID 83201-4008 | |
(208) 234-4700 | |
Not Available |
Full Name | Sulabha Chaganaboyana |
---|---|
Gender | Female |
Speciality | Family Practice |
Experience | 20 Years |
Location | 465 Memorial Dr, Pocatello, Idaho |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659668218 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 26025 (West Virginia) | Secondary |
207Q00000X | Family Medicine | 94-07773 (Kansas) | Secondary |
207Q00000X | Family Medicine | M13891 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Portneuf Medical Center | Pocatello, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Health West Inc | 4981500931 | 47 |
Entity Name | Health West Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033595541 PECOS PAC ID: 4981500931 Enrollment ID: O20031210000461 |
Entity Name | Saint Alphonsus Regional Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
Mailing Address | Practice Location Address |
---|---|
Sulabha Chaganaboyana, MD 500 S 11th Ave Ste 400, Pocatello, ID 83201-4880 Ph: (208) 232-7862 | Sulabha Chaganaboyana, MD 465 Memorial Dr, Pocatello, ID 83201-4008 Ph: (208) 234-4700 |
Shayna Larae Harding, APRN Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1133 Call Creek Dr # A, Pocatello, ID 83201 Phone: 208-232-1000 Fax: 208-232-1006 | |
Cody E Patterson, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 151 N 4th Ave, Pocatello, ID 83201 Phone: 208-269-7147 Fax: 208-416-6522 | |
Dr. Bradley Yamashita Beaufort, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-282-4700 Fax: 208-282-4696 | |
Ryan Hudgens, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 | |
Shaylor Bringhurst, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 | |
Dr. Sharla Clark, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1951 Bench Road, Suite B, Pocatello, ID 83201 Phone: 208-238-1000 Fax: 208-238-0009 | |
Marie Elwood, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 |