| Clark Joseph Wyatt, NP-C | |
|
1502 Locust St N Ste 600, Twin Falls, ID 83301-4164 | |
| (208) 734-6091 | |
| (208) 734-4654 |
| Full Name | Clark Joseph Wyatt |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 1502 Locust St N Ste 600, Twin Falls, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215448246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 57139 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Asthma And Allergy Of Idaho Pllc | 7416943782 | 6 |
| Asthma And Allergy Of Idaho Pllc | 7416943782 | 6 |
| Intermountain Healthcare Services, Inc | 1850209420 | 3063 |
| Entity Name | Asthma & Allergy Of Idaho Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427138734 PECOS PAC ID: 7416943782 Enrollment ID: O20090618000466 |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Joseph Wyatt, NP-C 1131 Cole St, Kimberly, ID 83341-5138 Ph: (208) 490-1901 | Clark Joseph Wyatt, NP-C 1502 Locust St N Ste 600, Twin Falls, ID 83301-4164 Ph: (208) 734-6091 |
Janice Carter, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2086 Addison Ave E, Twin Falls, ID 83301 Phone: 208-733-9697 Fax: 208-733-3197 | |
Lesley D. Goulding, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 302, Twin Falls, ID 83301 Phone: 208-814-8740 Fax: 208-814-8955 | |
Mrs. Amanda Jo Prestigiacomo, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 350 N Haven Dr, Twin Falls, ID 83301 Phone: 208-904-4780 Fax: 208-904-4832 | |
Mrs. Raemi Dawn Nolevanko, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Corinne Bartschi, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1502 Locust St N Ste 700, Twin Falls, ID 83301 Phone: 208-595-5095 | |
Jerri L Bingham, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Mr. Samuel Teagan Shaw, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1835 Harrison St N Unit 16104, Twin Falls, ID 83301 Phone: 208-431-3570 |