| Clark R Daines, MD | |
|
3100 Channing Way, Idaho Falls, ID 83404-7533 | |
| (208) 529-6050 | |
| (208) 529-7085 |
| Full Name | Clark R Daines |
|---|---|
| Gender | Male |
| Speciality | |
| Experience | Years |
| Location | 3100 Channing Way, Idaho 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 |
|---|---|---|---|
| 1144264045 | NPI | - | NPPES |
| M11914 | Other | ID | STATE LICENSE |
| 79892 | Other | ID | BLUE CROSS IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | M11914 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Clark R Daines, MD 1820 E 17th St, Ste 230, Idaho Falls, ID 83404-6469 Ph: (208) 529-9779 | Clark R Daines, MD 3100 Channing Way, Idaho Falls, ID 83404-7533 Ph: (208) 529-6050 |
Gary Earl Ellwein, MD Pathology Medicare: Medicare Enrolled Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Matt Tannenbaum, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Floyd Joseph Fantelli, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6050 Fax: 208-529-7085 | |
Dr. Gabriele Emma Teermann, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3100 Channing Way, Idaho Falls, ID 83404 Phone: 208-529-6048 Fax: 208-529-7085 |