| Pocatello Clinic Of Internal Medicine Pa | |
|
707 N 7th Pocatello ID 83201 | |
| (208) 233-4562 | |
| (208) 234-4638 |
| Full Name | Pocatello Clinic Of Internal Medicine Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 707 N 7th, Pocatello, Idaho |
| Authorized Official Name and Position | Mark P Benson (OWNER) |
| Authorized Official Contact | 2082334562 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pocatello Clinic Of Internal Medicine Pa Po Box 880 Pocatello ID 83204 Ph: (208) 233-4562 | Pocatello Clinic Of Internal Medicine Pa 707 N 7th Pocatello ID 83201 Ph: (208) 233-4562 |
| NPI Number | 1477671477 |
|---|---|
| Provider Enumeration Date | 03/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477671477 | NPI | - | NPPES |
| 29296 | Other | ID | GROUP BLUE SHIELD |
| CP9190 | Other | ID | GROUP RAILROAD MEDICARE |
| 88765 | Other | ID | GROUP BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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