| Donnelly Medical Clinic | |
|
454 Rosebury Road Suite 103 Donnelly ID 83615 | |
| (208) 325-4455 | |
| (208) 325-4466 |
| Full Name | Donnelly Medical Clinic |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 454 Rosebury Road, Donnelly, Idaho |
| Authorized Official Name and Position | Jacqueline R Bruns (VP - PHYSICIAN SERVICES) |
| Authorized Official Contact | 2086344061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donnelly Medical Clinic Po Box 1047 Mccall ID 83638-1047 Ph: (208) 325-4455 | Donnelly Medical Clinic 454 Rosebury Road Suite 103 Donnelly ID 83615 Ph: (208) 325-4455 |
| NPI Number | 1902937196 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 03/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902937196 | NPI | - | NPPES |
| 8N006 | Other | ID | BC |
| 000010160243 | Other | ID | BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Korena Popp Fnp Medical Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615 Phone: 208-325-3500 Fax: 208-325-3501 | |
Cascade Medical Center Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 454 W Roseberry Road, Suite 103, Donnelly, ID 83615 Phone: 208-382-4285 Fax: 208-382-5081 |