| Dr Carl Scott Humphrey, MD | |
|
3381 W Bavaria Street, Eagle, ID 83616-5341 | |
| (208) 639-4800 | |
| (208) 639-4801 |
| Full Name | Dr Carl Scott Humphrey |
|---|---|
| Gender | Male |
| Speciality | Orthopedic Surgery |
| Experience | 25 Years |
| Location | 3381 W Bavaria Street, Eagle, Idaho |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811978778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | M9563 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boise Shoulder Clinic, Pa | 4688671621 | 3 |
| Entity Name | Boise Shoulder Clinic, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760581409 PECOS PAC ID: 4688671621 Enrollment ID: O20061103000362 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Carl Scott Humphrey, MD 3381 W Bavaria Street, Eagle, ID 83616-5341 Ph: (208) 639-4800 | Dr Carl Scott Humphrey, MD 3381 W Bavaria Street, Eagle, ID 83616-5341 Ph: (208) 639-4800 |
Dr. Lisa R Rendon, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 3381 W Bavaria St, Eagle, ID 83616 Phone: 208-287-1110 Fax: 208-639-4801 | |
Dr. Joseph Gordon Daines, M.D. Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 766 W Colchester Dr, Eagle, ID 83616 Phone: 208-401-4790 | |
Dr. Vipul N Nanavati, MD, BSME, CAQH Orthopedic Surgery Medicare: Medicare Enrolled Practice Location: 3381 W Bavaria St, Eagle, ID 83616 Phone: 208-639-4800 Fax: 208-639-4801 |