| Jeff E Brockett, EDD | |
|
650 Memorial Dr Bldg 68, Pocatello, ID 83209-0001 | |
| (208) 282-2556 | |
| Not Available |
| Full Name | Jeff E Brockett |
|---|---|
| Gender | Male |
| Speciality | Qualified Audiologist |
| Experience | 38 Years |
| Location | 650 Memorial Dr Bldg 68, Pocatello, 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 |
|---|---|---|---|
| 1013931450 | NPI | - | NPPES |
| 004413800 | Medicaid | ID | |
| AU787 | Other | ID | BLUE CROSS GROUP # AU753 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 231H00000X | Audiologist | AUD1233 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Idaho State University | 4688683030 | 17 |
| Provider Name | Idaho State University |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1952474777 PECOS PAC ID: 4688683030 Enrollment ID: O20060412000292 |
| Provider Name | Mv Pocatello Ent, Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1154801595 PECOS PAC ID: 2567706096 Enrollment ID: O20181210002621 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeff E Brockett, EDD 650 Memorial Drive, Box 8116, Pocatello, ID 83209 Ph: (208) 282-2556 | Jeff E Brockett, EDD 650 Memorial Dr Bldg 68, Pocatello, ID 83209-0001 Ph: (208) 282-2556 |
Dr. Makenzi Gwinn, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way Ste 115, Pocatello, ID 83201 Phone: 208-239-1960 Fax: 208-478-0076 | |
Mr. Edward Gregory Smith, M.S., CCC-A Audiologist Medicare: Not Enrolled in Medicare Practice Location: 921 S 8th Ave Stop 8116, Pocatello, ID 83209 Phone: 208-282-3495 Fax: 208-282-4571 | |
Dr. Jennifer Holst, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: Idaho State University, 921 S. 8th Stop 8116, Pocatello, ID 83209 Phone: 208-282-3747 | |
Dr. Mary M. Whitaker, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: 650 Memorial Drive, Bldg 68, Pocatello, ID 83209 Phone: 208-282-2190 | |
Lindsay Anne Tucker, AU.D. Audiologist Medicare: Medicare Enrolled Practice Location: 650 Memorial Dr, Pocatello, ID 83209 Phone: 208-233-4339 | |
Dr. Alisa Vineyard, AU.D. Audiologist Medicare: Accepting Medicare Assignments Practice Location: 2350 Via Caporatti Dr, Suite B, Pocatello, ID 83201 Phone: 208-237-5322 |