| |
36 W Court St, Weiser, ID 83672-1941 | |
(208) 414-1600 | |
(208) 414-1607 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 36 W Court St, Weiser, Idaho |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184994147 | NPI | - | NPPES |
0008449 | Medicaid | ID | |
814368000 | Other | BLUE CROSS / BLUE SHIELD | |
P00102776 | Other | RR MEDICARE | |
V4999 | Other | BLUE CROSS | |
000010137310 | Other | BLUE SHIELD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | ODD649 (Idaho) | Primary |
Mailing Address | Practice Location Address |
---|---|
36 W Court St, Weiser, ID 83672-1941 Ph: (208) 414-1600 | 36 W Court St, Weiser, ID 83672-1941 Ph: (208) 414-1600 |
Dr. Steven G Iwasa, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 36 W Court St, Weiser, ID 83672 Phone: 208-414-1600 Fax: 208-414-1607 |