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2020 S Johns Ave Ste B Emmett ID 83617-9410 | |
(208) 369-4340 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 2020 S Johns Ave Ste B, Emmett, Idaho |
Authorized Official Name and Position | Jonathan Bret Barrus (PHYSICIAN/OWNER) |
Authorized Official Contact | 2083694340 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2020 S Johns Ave Ste B Emmett ID 83617-9410 Ph: (208) 369-4340 | 2020 S Johns Ave Ste B Emmett ID 83617-9410 Ph: (208) 369-4340 |
NPI Number | 1699375659 |
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Provider Enumeration Date | 10/29/2020 |
Last Update Date | 01/25/2024 |
Medicare PECOS PAC ID | 8729489620 |
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Medicare Enrollment ID | O20210630000052 |
Identifier | Type | State | Issuer |
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1699375659 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Brett T Mumford |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1164463113 PECOS PAC ID: 4880592112 Enrollment ID: I20031223000750 |
Provider Name | Jonathan Barrus |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346654589 PECOS PAC ID: 8628295839 Enrollment ID: I20160906002281 |
The Smith Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 119 N Wardwell Ave, Emmett, ID 83617 Phone: 208-365-6311 | |
Gem Family Practice, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 S Washington Ave, Emmett, ID 83617 Phone: 208-365-3455 Fax: 208-365-3422 | |