| Dr Forrest R Fredline, DO | |
|
4400 E Flamingo Ave Ste 200, Nampa, ID 83687 | |
| (208) 302-2700 | |
| (208) 302-2725 |
| Full Name | Dr Forrest R Fredline |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 17 Years |
| Location | 4400 E Flamingo Ave Ste 200, Nampa, 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 |
|---|---|---|---|
| 1245493840 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 5101017665 (Michigan) | Secondary |
| 208600000X | Surgery | O-0712 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | 3476462359 | 541 |
| Entity Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Forrest R Fredline, DO 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 302-2700 | Dr Forrest R Fredline, DO 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Ph: (208) 302-2700 |
Matthew J. Wood, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1512 12th Ave Rd, Nampa, ID 83686 Phone: 208-463-5029 | |
Dennis Weiler, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3918 Chicago St, Nampa, ID 83686 Phone: 208-467-5155 | |
Christian P Vetsch, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-463-3141 Fax: 208-463-3044 | |
Richard J Martin, MD Surgery Medicare: Medicare Enrolled Practice Location: 4400 E Flamingo, Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Michael A Nizzi, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Katherine Homer, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 |