| Benjamin Leishman, DO | |
|
1582 Elk Creek Dr, Idaho Falls, ID 83404-8322 | |
| (208) 881-0227 | |
| Not Available |
| Full Name | Benjamin Leishman |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1582 Elk Creek Dr, Idaho Falls, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063862977 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | O-1351 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | O-1351 (Idaho) | Primary |
| Entity Name | Mountain View Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343 |
| Entity Name | Community Care West Side Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295009785 PECOS PAC ID: 3678738218 Enrollment ID: O20120703000554 |
| Entity Name | Cc Pocatello Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538517156 PECOS PAC ID: 8527353176 Enrollment ID: O20160822003018 |
| Mailing Address | Practice Location Address |
|---|---|
| Benjamin Leishman, DO 1582 Elk Creek Dr, Idaho Falls, ID 83404-8322 Ph: (208) 881-0227 | Benjamin Leishman, DO 1582 Elk Creek Dr, Idaho Falls, ID 83404-8322 Ph: (208) 881-0227 |
Dr. Matthew Scott Payne, D.O Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3200 Channing Way Ste 304, Idaho Falls, ID 83404 Phone: 208-535-4580 Fax: 208-535-4520 | |
Matthew G Taylor, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3200 Channing Way Ste 205, Idaho Falls, ID 83404 Phone: 208-535-4580 Fax: 208-535-4520 | |
Michael Thomas Long, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 2265 Desoto St, Idaho Falls, ID 83404 Phone: 208-569-7139 | |
Dr. Peter Jeffrey Thompson, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1995 E 17th St, Idaho Falls, ID 83404 Phone: 208-529-5252 Fax: 208-529-4434 | |
Dr. Eric Bennett, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2775 Channing Way, Idaho Falls, ID 83404 Phone: 208-524-0133 | |
Wallace C Baker, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1880 John Adams Pkwy, Idaho Falls, ID 83401 Phone: 208-524-6633 Fax: 208-524-9952 |