| Dr Delray Maughan, MD | |
|
13900 W Wainwright Dr Ste 102, Boise, ID 83713-5028 | |
| (208) 938-5823 | |
| (208) 938-5306 |
| Full Name | Dr Delray Maughan |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 13900 W Wainwright Dr Ste 102, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649253188 | NPI | - | NPPES |
| 002592700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | M4908 (Idaho) | Primary |
| Entity Name | Idaho Ear Clinic Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154976983 PECOS PAC ID: 2668703687 Enrollment ID: O20191004002956 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Delray Maughan, MD 13900 W Wainwright Dr Ste 102, Boise, ID 83713-5028 Ph: (208) 938-5823 | Dr Delray Maughan, MD 13900 W Wainwright Dr Ste 102, Boise, ID 83713-5028 Ph: (208) 938-5823 |
Seung Yong Ji, MD Otolaryngology Medicare: Medicare Enrolled Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-336-4368 | |
Mrs. Tiffany Kearny, PA Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-367-7423 | |
Dr. Eric T Garner, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St, Ste 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-367-7474 | |
Dr. Jacob G Robison, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 100 E Idaho St, Boise, ID 83712 Phone: 208-381-9590 | |
Dr. Todd Rustad, M.D. Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 900 N Liberty St, Ste 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-367-7474 | |
Tyson Nielsen, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-267-3979 | |
David Michael Lewis, DO Otolaryngology Medicare: Medicare Enrolled Practice Location: 900 N Liberty St Ste 400, Boise, ID 83704 Phone: 208-367-3320 |