Physicians And Surgeons Of Shelley | |
275 W Locust St Shelley ID 83274-1230 | |
(208) 782-2960 | |
Not Available |
Full Name | Physicians And Surgeons Of Shelley |
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Speciality | Clinic/Center |
Location | 275 W Locust St, Shelley, Idaho |
Authorized Official Name and Position | Jacob Erickson (CEO) |
Authorized Official Contact | 2087853801 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Physicians And Surgeons Of Shelley 275 W Locust St Shelley ID 83274-1230 Ph: (208) 782-2960 | Physicians And Surgeons Of Shelley 275 W Locust St Shelley ID 83274-1230 Ph: (208) 782-2960 |
NPI Number | 1366630949 |
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Provider Enumeration Date | 10/09/2007 |
Last Update Date | 02/11/2021 |
Medicare PECOS PAC ID | 8426149758 |
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Medicare Enrollment ID | O20080414000440 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366630949 | NPI | - | NPPES |
8N304 | Other | ID | BLUE CROSS OF IDAHO |
807947000 | Medicaid | ID | |
000010137702 | Other | ID | BLUE SHIELD OF IDAHO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 36 (Idaho) | Primary |
261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
Shelley Family Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 S Emerson St, Shelley, ID 83274 Phone: 208-357-7404 | |
Bingham Memorial Physicians And Surgeons Clinic Of Shelley Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 275 W Locust St, Shelley, ID 83274 Phone: 208-785-4100 | |
Shelley Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 210 S Emerson Ave, Shelley, ID 83274 Phone: 208-357-7404 | |
Shelley Chiropractic, P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 528 N State St, Shelley, ID 83274 Phone: 208-357-0333 Fax: 208-357-2299 |