Dr Randal Lee Wraalstad, DPM | |
762 N College Rd Ste A, Twin Falls, ID 83301-5392 | |
(208) 814-7150 | |
(208) 814-7170 |
Full Name | Dr Randal Lee Wraalstad |
---|---|
Gender | Male |
Speciality | Podiatry |
Experience | 30 Years |
Location | 762 N College Rd Ste A, Twin Falls, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255334066 | NPI | - | NPPES |
804243900 | Medicaid | ID | |
P00899555 | Other | ID | MCRR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | P152 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
St Luke's Jerome | Jerome, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Lukes Clinic Llc | 1052217478 | 274 |
Provider Name | St Lukes Clinic Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
Mailing Address | Practice Location Address |
---|---|
Dr Randal Lee Wraalstad, DPM 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Dr Randal Lee Wraalstad, DPM 762 N College Rd Ste A, Twin Falls, ID 83301-5392 Ph: (208) 814-7150 |
Dr. Craig D Holman, DPM Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 496 Shoup Ave W Ste B, Twin Falls, ID 83301 Phone: 208-734-7676 Fax: 208-736-8378 | |
Daniel Matthew Wettstein, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 476 Cheney Drive West, Twin Falls, ID 83301 Phone: 208-731-6321 Fax: 801-475-5286 | |
South Idaho Foot And Ankle Clinic Podiatrist Medicare: Medicare Enrolled Practice Location: 191 Addison Ave, Twin Falls, ID 83301 Phone: 208-733-3881 Fax: 208-734-8441 | |
Advanced Foot & Ankle Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 176 Falls Ave Ste 200, Twin Falls, ID 83301 Phone: 208-731-6321 Fax: 208-944-0430 | |
David A Blackmer, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 191 Addison Ave, Twin Falls, ID 83301 Phone: 208-733-3881 Fax: 208-733-8441 | |
Magic Valley Foot & Ankle Specialist Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 496 Shoup Ave W # B, Twin Falls, ID 83301 Phone: 208-734-7676 Fax: 208-736-8378 |