| |
15630 N Highway 41, Rathdrum, ID 83858-8710 | |
(208) 687-0370 | |
(208) 687-0470 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 15630 N Highway 41, Rathdrum, Idaho |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972658169 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | ODP-100109 (Idaho) | Primary |
Provider Name | Brian R Miller |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1710978473 PECOS PAC ID: 1254430176 Enrollment ID: I20070619000081 |
Provider Name | Brian P Finley |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1649571118 PECOS PAC ID: 8325272495 Enrollment ID: I20221028002591 |
Mailing Address | Practice Location Address |
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15630 N Highway 41, Rathdrum, ID 83858-8710 Ph: (208) 687-0370 | 15630 N Highway 41, Rathdrum, ID 83858-8710 Ph: (208) 687-0370 |
Brian Richard Miller, OD Optometrist Medicare: May Accept Medicare Assignments Practice Location: 15630 N Highway 41, Rathdrum, ID 83858 Phone: 208-687-0370 Fax: 208-687-0470 |