| Dorchuck Medical Inc | |
|
801 E Mullan Avenue Osburn ID 83849-0596 | |
| (208) 556-4803 | |
| (208) 556-1023 |
| Full Name | Dorchuck Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 801 E Mullan Avenue, Osburn, Idaho |
| Authorized Official Name and Position | Ronald W Dorchuck (OWNER) |
| Authorized Official Contact | 2085564803 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dorchuck Medical Inc Po Box 596 Osburn ID 83849-0596 Ph: (208) 556-4803 | Dorchuck Medical Inc 801 E Mullan Avenue Osburn ID 83849-0596 Ph: (208) 556-4803 |
| NPI Number | 1144300906 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 12/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144300906 | NPI | - | NPPES |
| 8M580 | Other | ID | BLUE CROSS |
| DD9081 | Other | ID | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-6906 (Idaho) | Primary |
| 225100000X | Physical Therapist | PT-1871 (Idaho) | Secondary |
Osburn Family Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 801 E Mullan Avenue, Osburn, ID 83849 Phone: 208-556-4803 Fax: 208-556-1023 |