| Direct Doctor Care Pllc | |
|
509 S Middleton Rd Ste 105 Middleton ID 83644-6047 | |
| (208) 668-2080 | |
| Not Available |
| Full Name | Direct Doctor Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 509 S Middleton Rd Ste 105, Middleton, Idaho |
| Authorized Official Name and Position | Roger Wyatt (OWNER) |
| Authorized Official Contact | 2089654899 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Direct Doctor Care Pllc 509 S Middleton Rd Ste 105 Middleton ID 83644-6047 Ph: (208) 965-4899 | Direct Doctor Care Pllc 509 S Middleton Rd Ste 105 Middleton ID 83644-6047 Ph: (208) 668-2080 |
| NPI Number | 1871112094 |
|---|---|
| Provider Enumeration Date | 04/09/2020 |
| Last Update Date | 04/09/2020 |
| Medicare PECOS PAC ID | 2264863281 |
|---|---|
| Medicare Enrollment ID | O20200507001024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871112094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Roger Tracy Wyatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326305004 PECOS PAC ID: 6800101213 Enrollment ID: I20150813011976 |
Terry Reilly Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 S Paradise Ave, Middleton, ID 83644 Phone: 208-849-9070 Fax: 208-510-5619 | |
Terry Reilly Health Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 201 S Paradise Ave, Middleton, ID 83644 Phone: 208-585-0048 Fax: 208-466-5359 |