| Beverly Hanson, PA | |
|
98 Poplar St, Blackfoot, ID 83221-1758 | |
| (208) 782-3993 | |
| (208) 782-3994 |
| Full Name | Beverly Hanson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Surgical |
| Location | 98 Poplar St, Blackfoot, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003874389 | NPI | - | NPPES |
| 000010167603 | Other | ID | RBS LAMERE |
| HPAC6 | Other | ID | BLUE CROSS OLD |
| PAJ80 | Other | ID | BCS LAMERE |
| 000010154328 | Other | ID | REGENCE BLUE SHIELD |
| HB405 | Other | ID | BLUE CROSS |
| 807338600 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | PAG-012 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Beverly Hanson, PA 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 782-3993 | Beverly Hanson, PA 98 Poplar St, Blackfoot, ID 83221-1758 Ph: (208) 782-3993 |
John Todd Allen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-1200 | |
Alyssa M Woodbury, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-2220 | |
Shawna Marie Reynolds, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 Fax: 208-785-1762 | |
Heather Faye Grimmett, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Lucas P Belford, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-1200 | |
Ryan Blair Killpack, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 |