| Mountain Crest Foot And Ankle Pa | |
|
3652 Washington Pkwy, Idaho Falls, ID 83404-7573 | |
| (208) 528-8700 | |
| (208) 528-2802 |
| Full Name | Mountain Crest Foot And Ankle Pa |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 3652 Washington Pkwy, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932191996 | NPI | - | NPPES |
| 806462800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | P-169 (Idaho) | Primary |
| Provider Name | Timothy R Black |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1578753091 PECOS PAC ID: 0244329738 Enrollment ID: I20071207000164 |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Crest Foot And Ankle Pa 3652 Washington Pkwy, Idaho Falls, ID 83404-7573 Ph: (208) 528-8700 | Mountain Crest Foot And Ankle Pa 3652 Washington Pkwy, Idaho Falls, ID 83404-7573 Ph: (208) 528-8700 |
Idaho Foot And Ankle Center Podiatrist Medicare: Medicare Enrolled Practice Location: 1540 Elk Creek Dr, Idaho Falls, ID 83404 Phone: 208-529-8393 | |
Ankle And Foot Clinic Of Idaho Podiatrist Medicare: Medicare Enrolled Practice Location: 2920 Cortez Ave, Idaho Falls, ID 83404 Phone: 208-529-0229 Fax: 888-688-3439 | |
Therapeutic Shoes Inc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 718 Beulahs Lane, Idaho Falls, ID 83401 Phone: 208-524-1995 Fax: 208-524-1995 | |
Andrew L Mccall, D.P.M. P.A. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2920 Cortez Ave, Idaho Falls, ID 83404 Phone: 208-529-0229 Fax: 888-688-3439 | |
Idaho Foot Center Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1540 Elk Creek Dr, Idaho Falls, ID 83404 Phone: 208-529-8393 Fax: 208-529-8398 | |
Dr. Kylin Kovac, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1540 Elk Creek Dr, Idaho Falls, ID 83404 Phone: 208-529-8393 Fax: 208-529-8398 | |
Foot & Ankle Specialists Of Idaho, P.c. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1277 E 17th St, Idaho Falls, ID 83404 Phone: 267-644-6880 |