| Lavonne R. Mills, Md | |
|
3307 N Stephanie Rd Pocatello ID 83204-7285 | |
| (208) 705-5116 | |
| Not Available |
| Full Name | Lavonne R. Mills, Md |
|---|---|
| Speciality | Family Medicine |
| Location | 3307 N Stephanie Rd, Pocatello, Idaho |
| Authorized Official Name and Position | Lavonne R. Mills (OWNER/PRESIDENT) |
| Authorized Official Contact | 2082361600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavonne R. Mills, Md Po Box 4699 Pocatello ID 83205-4699 Ph: (208) 236-1600 | Lavonne R. Mills, Md 3307 N Stephanie Rd Pocatello ID 83204-7285 Ph: (208) 705-5116 |
| NPI Number | 1417118787 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417118787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M4489 (Idaho) | Primary |
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