W Michael Mcdonnell, MD | |
500 W. Fort St., # 111, Boise, ID 83702 | |
(208) 422-1000 | |
(208) 422-1319 |
Full Name | W Michael Mcdonnell |
---|---|
Gender | Male |
Speciality | Internal Medicine - Gastroenterology |
Location | 500 W. Fort St., 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 |
---|---|---|---|
1942241104 | NPI | - | NPPES |
0115863 | Other | WA | LABOR AND INDUSTRY |
MD00035287 | Other | WA | STATE LICENSE NUMBER |
8209629 | Medicaid | WA | |
100010270 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | MD00035287 (Washington) | Primary |
Entity Name | Prosser Public Hospital District Of Benton County |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306897681 PECOS PAC ID: 6709787872 Enrollment ID: O20040120000974 |
Mailing Address | Practice Location Address |
---|---|
W Michael Mcdonnell, MD 500 W. Fort St., # 111, Boise, ID 83702 Ph: (208) 422-1000 | W Michael Mcdonnell, MD 500 W. Fort St., # 111, Boise, ID 83702 Ph: (208) 422-1000 |
Dr. Jennifer A Hofstra, MD Gastroenterology 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 Gastroenterology Medicare: Not Enrolled in Medicare Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3104 | |
Dr. Michael Frederic Krug, M.D. Gastroenterology 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. Gastroenterology 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 Gastroenterology 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 Gastroenterology 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. Gastroenterology Medicare: Accepting Medicare Assignments Practice Location: 6259 W Emerald St, Boise, ID 83704 Phone: 208-489-1900 Fax: 208-375-5286 |