Indian Trail Geriatric Medicine | |
422 W Riverside Ave Ste 1100 Spokane WA 99201-0302 | |
(509) 464-1600 | |
(509) 343-9391 |
Full Name | Indian Trail Geriatric Medicine |
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Speciality | Family Medicine |
Location | 422 W Riverside Ave Ste 1100, Spokane, Washington |
Authorized Official Name and Position | Eric A Sohn (OWNER) |
Authorized Official Contact | 5098697533 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Indian Trail Geriatric Medicine 1818 W Francis Ave # 385 Spokane WA 99205-6834 Ph: (509) 464-1600 | Indian Trail Geriatric Medicine 422 W Riverside Ave Ste 1100 Spokane WA 99201-0302 Ph: (509) 464-1600 |
NPI Number | 1689674244 |
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Provider Enumeration Date | 07/26/2005 |
Last Update Date | 10/20/2023 |
Medicare PECOS PAC ID | 8022000330 |
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Medicare Enrollment ID | O20040330000634 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689674244 | NPI | - | NPPES |
MD37099 | Other | WA | WA LICENSE |
MD7619 | Other | ID | IDAHO LICENSE |
1016357 | Medicaid | WA |
Provider Name | Eric Allen Sohn |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144220609 PECOS PAC ID: 6002808326 Enrollment ID: I20040520001275 |
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