| Bingham Healthcare Specialty Clinic - 4th St | |
|
353 N 4th Ave Pocatello ID 83201-6390 | |
| (208) 478-7900 | |
| (208) 478-7901 |
| Full Name | Bingham Healthcare Specialty Clinic - 4th St |
|---|---|
| Speciality | Family Medicine |
| Location | 353 N 4th Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Jacob Erickson (CEO) |
| Authorized Official Contact | 2087853801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bingham Healthcare Specialty Clinic - 4th St 98 Poplar St Blackfoot ID 83221-1758 Ph: (208) 785-4100 | Bingham Healthcare Specialty Clinic - 4th St 353 N 4th Ave Pocatello ID 83201-6390 Ph: (208) 478-7900 |
| NPI Number | 1134621436 |
|---|---|
| Provider Enumeration Date | 03/02/2018 |
| Last Update Date | 02/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134621436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208600000X | Surgery | (* (Not Available)) | Secondary |
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