Mr James Picanco Sr, PA-C is a
Physician Assistant based in Fort Hall, Idaho. Mr James Picanco Sr is licensed to practice in Texas (license number PA01153) and his current practice location is
Mission Road, Fort Hall, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 238-5427.
NPI number for Mr James Picanco Sr is 1407862139 and his current mailing address is Mission Road, Fort Hall, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1407862139.
Provider's Profile
Full Name | Mr James Picanco Sr |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | Mission Road, Fort Hall, Idaho |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1407862139
- Provider Enumeration Date: 08/01/2006
- Last Update Date: 07/18/2007
Medical Identifiers
Medical identifiers for Mr James Picanco Sr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407862139 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | PA01153 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr James Picanco Sr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr James Picanco Sr, PA-C Mission Road, Fort Hall, ID 83203-0717 Ph: (208) 238-5427 | Mr James Picanco Sr, PA-C Mission Road, Fort Hall, ID 83203-0717 Ph: (208) 238-5427 |
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