| Ennis Endocrinology, Pllc | |
|
2450 E Gala St Ste 100 Meridian ID 83642-4805 | |
| (208) 994-8180 | |
| (208) 908-4542 |
| Full Name | Ennis Endocrinology, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2450 E Gala St Ste 100, Meridian, Idaho |
| Authorized Official Name and Position | Robert Frank Ennis (PHYSICIAN) |
| Authorized Official Contact | 2089948180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ennis Endocrinology, Pllc 2498 W Timber Dr Eagle ID 83616-4665 Ph: (208) 994-8180 | Ennis Endocrinology, Pllc 2450 E Gala St Ste 100 Meridian ID 83642-4805 Ph: (208) 994-8180 |
| NPI Number | 1902143134 |
|---|---|
| Provider Enumeration Date | 01/08/2013 |
| Last Update Date | 04/09/2020 |
| Medicare PECOS PAC ID | 9234377391 |
|---|---|
| Medicare Enrollment ID | O20130530000710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902143134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | M-11309 (Idaho) | Primary |
| Provider Name | Robert F Ennis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1366647729 PECOS PAC ID: 6002902814 Enrollment ID: I20110721000334 |
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