| Michael R Flandro Od Pa | |
|
360 S Arthur Ave Pocatello ID 83204-3307 | |
| (208) 232-6675 | |
| (208) 232-5800 |
| Full Name | Michael R Flandro Od Pa |
|---|---|
| Speciality | Clinic/center |
| Location | 360 S Arthur Ave, Pocatello, Idaho |
| Authorized Official Name and Position | Michael Reese Flandro (OWNER/PRESIDENT) |
| Authorized Official Contact | 2082326675 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R Flandro Od Pa 360 S Arthur Ave Pocatello ID 83204-3307 Ph: (208) 232-6675 | Michael R Flandro Od Pa 360 S Arthur Ave Pocatello ID 83204-3307 Ph: (208) 232-6675 |
| NPI Number | 1922257823 |
|---|---|
| Provider Enumeration Date | 09/16/2008 |
| Last Update Date | 07/21/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922257823 | NPI | - | NPPES |
| 000010015363 | Other | ID | REGENCE BLUE SHIELD OF IDAHO |
| 410039268 | Other | ID | MEDICARE RAILROAD RETIREMENT BOARD |
| 002622900 | Medicaid | ID | |
| V2811 | Other | ID | BLUE CROSS OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ODP-702 (Idaho) | Primary |
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