| Bradley Meyer, | |
|
801 Pole Line Rd W, Twin Falls, ID 83301-5810 | |
| (208) 814-8500 | |
| Not Available |
| Full Name | Bradley Meyer |
|---|---|
| Gender | Male |
| Speciality | Obstetrics & Gynecology |
| Location | 801 Pole Line Rd W, Twin 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 |
|---|---|---|---|
| 1073074720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | M-16705 (Idaho) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Meyer, 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Bradley Meyer, 801 Pole Line Rd W, Twin Falls, ID 83301-5810 Ph: (208) 814-8500 |
Dr. Michael J Cannon, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W Ste 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-933-9635 | |
David C Allen, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-734-4143 | |
Laura M Fall, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-814-8596 | |
Dr. Susan M Marzolf, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W Ste 3880, Twin Falls, ID 83301 Phone: 208-814-8500 | |
Darren W Coleman, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-734-4143 | |
Dr. Matthew H Packham, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-734-4143 |