| West Family Medicine | |
|
1133 Call Creek Place Suite A Pocatello ID 83201 | |
| (208) 232-1000 | |
| Not Available |
| Full Name | West Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1133 Call Creek Place, Pocatello, Idaho |
| Authorized Official Name and Position | Brandon A. West (OWNER) |
| Authorized Official Contact | 2082321000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Family Medicine Po Box 4868 Pocatello ID 83205-4868 Ph: (208) 232-1000 | West Family Medicine 1133 Call Creek Place Suite A Pocatello ID 83201 Ph: (208) 232-1000 |
| NPI Number | 1780808022 |
|---|---|
| Provider Enumeration Date | 04/11/2007 |
| Last Update Date | 08/18/2021 |
| Medicare PECOS PAC ID | 1153644075 |
|---|---|
| Medicare Enrollment ID | O20141230001043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780808022 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0000X | Family Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
| Provider Name | Brandon A West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750490660 PECOS PAC ID: 8224029079 Enrollment ID: I20040520000448 |
| Provider Name | Karen D Donaldson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699705087 PECOS PAC ID: 9931224631 Enrollment ID: I20100918000054 |
| Provider Name | Paul K Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386682862 PECOS PAC ID: 6305930934 Enrollment ID: I20140528002166 |
| Provider Name | Andrea Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376992503 PECOS PAC ID: 6002102746 Enrollment ID: I20160907001312 |
| Provider Name | Shayna Larae Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043880669 PECOS PAC ID: 7113322926 Enrollment ID: I20210817002505 |
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