| Ross Ginkel Psyd Pllc | |
|
750 W Ustick Rd Suite 120 Meridian ID 83646-6133 | |
| (208) 366-1601 | |
| (208) 366-1602 |
| Full Name | Ross Ginkel Psyd Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 750 W Ustick Rd, Meridian, Idaho |
| Authorized Official Name and Position | Ross Ginkel (OWNER) |
| Authorized Official Contact | 5039392484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ross Ginkel Psyd Pllc 750 W Ustick Rd Suite 120 Meridian ID 83646-6133 Ph: (208) 366-1601 | Ross Ginkel Psyd Pllc 750 W Ustick Rd Suite 120 Meridian ID 83646-6133 Ph: (208) 366-1601 |
| NPI Number | 1982142071 |
|---|---|
| Provider Enumeration Date | 02/08/2017 |
| Last Update Date | 02/08/2017 |
| Medicare PECOS PAC ID | 8729363411 |
|---|---|
| Medicare Enrollment ID | O20170421001990 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982142071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY 203014 (Idaho) | Primary |
| Provider Name | Ross William Ginkel |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1568806016 PECOS PAC ID: 7416199740 Enrollment ID: I20170424000581 |
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