| Northwest Gastroenterology, Pllc | |
|
526 Shoup Ave W Twin Falls ID 83301-6050 | |
| (208) 736-7620 | |
| (855) 830-4058 |
| Full Name | Northwest Gastroenterology, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 526 Shoup Ave W, Twin Falls, Idaho |
| Authorized Official Name and Position | Judith Erika Csanky (SOLE OWNER) |
| Authorized Official Contact | 5035053628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Gastroenterology, Pllc 2156 Eaglecrest Dr Filer ID 83328-5068 Ph: (503) 505-3628 | Northwest Gastroenterology, Pllc 526 Shoup Ave W Twin Falls ID 83301-6050 Ph: (208) 736-7620 |
| NPI Number | 1881100097 |
|---|---|
| Provider Enumeration Date | 12/26/2017 |
| Last Update Date | 06/19/2020 |
| Medicare PECOS PAC ID | 1850650920 |
|---|---|
| Medicare Enrollment ID | O20180117002659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881100097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | M-11559 (Idaho) | Primary |
| Provider Name | Judith Csanky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598843039 PECOS PAC ID: 5597798264 Enrollment ID: I20120329000636 |
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