Dr Terry Evert Davenport, DO | |
229 S 8th St, St Maries, ID 83861-1813 | |
(208) 245-2591 | |
(208) 245-5246 |
Full Name | Dr Terry Evert Davenport |
---|---|
Gender | Male |
Speciality | Family Practice |
Experience | 33 Years |
Location | 229 S 8th St, St Maries, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710974191 | NPI | - | NPPES |
601415700 | Other | DEEIOC | |
S1303 | Other | ID | BLUE CROSS OF ID |
123363 | Other | WA | DEPT OF LABOR&INDUSTRIES |
8434839 | Medicaid | WA | |
805169900 | Medicaid | ID | |
000010004699 | Other | ID | REGENCE BS OF ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208M00000X | Hospitalist | O-130 (Idaho) | Secondary |
207Q00000X | Family Medicine | O-130 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Hospice Of North Idaho | Hayden, ID | Hospice |
Benewah Community Hospital | St maries, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Benewah Community Hospital | 1850200700 | 28 |
Entity Name | Benewah Community Hospital |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386632180 PECOS PAC ID: 1850200700 Enrollment ID: O20040927000265 |
Entity Name | Benewah Community Hospital |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1548320435 PECOS PAC ID: 1850200700 Enrollment ID: O20061104000136 |
Mailing Address | Practice Location Address |
---|---|
Dr Terry Evert Davenport, DO 229 S 8th St, St Maries, ID 83861-1813 Ph: (208) 245-2591 | Dr Terry Evert Davenport, DO 229 S 8th St, St Maries, ID 83861-1813 Ph: (208) 245-2591 |
Karen D Libsch, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 229 S 8th St, St Maries, ID 83861 Phone: 208-245-2591 Fax: 208-245-5246 | |
Mrs. Stephanie Marie Arar, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 229 S 7th St, St Maries, ID 83861 Phone: 208-245-5551 Fax: 208-245-5246 | |
Dr. Daniel Cooper Wester, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 229 S 7th St, St Maries, ID 83861 Phone: 208-245-5551 Fax: 208-245-5246 |