| Craig J Denny Md Prof | |
|
2280 E 25th St Idaho Falls ID 83404-7542 | |
| (208) 227-2100 | |
| Not Available |
| Full Name | Craig J Denny Md Prof |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2280 E 25th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Juli Popejoy (BILLING MANAGER) |
| Authorized Official Contact | 2085252090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig J Denny Md Prof Po Box 3354 Idaho Falls ID 83403-3354 Ph: (208) 525-2090 | Craig J Denny Md Prof 2280 E 25th St Idaho Falls ID 83404-7542 Ph: (208) 227-2100 |
| NPI Number | 1932552379 |
|---|---|
| Provider Enumeration Date | 07/21/2016 |
| Last Update Date | 09/28/2016 |
| Medicare PECOS PAC ID | 7911953161 |
|---|---|
| Medicare Enrollment ID | O20050330000820 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932552379 | NPI | - | NPPES |
| 1720071319 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M-9188 (Idaho) | Primary |
| Provider Name | Craig J Denny |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720071319 PECOS PAC ID: 1456319300 Enrollment ID: I20050412001214 |
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