| Dr Gregory D Pennock, MD | |
|
423 N Third Ave Ste 335, Sandpoint, ID 83864 | |
| (208) 265-7070 | |
| (208) 265-7071 |
| Full Name | Dr Gregory D Pennock |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine - Cardiovascular Disease |
| Location | 423 N Third Ave Ste 335, Sandpoint, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700889607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RC0000X | Internal Medicine - Cardiovascular Disease | M12621 (Idaho) | Primary |
| Entity Name | Kootenai Health, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230 |
| Entity Name | Pocatello Health Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689802852 PECOS PAC ID: 6608927637 Enrollment ID: O20090701000646 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Gregory D Pennock, MD 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-5085 | Dr Gregory D Pennock, MD 423 N Third Ave Ste 335, Sandpoint, ID 83864 Ph: (208) 265-7070 |
Dr. Russell R Blakeley, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 606 N Third Ave, Suite 203, Sandpoint, ID 83864 Phone: 208-263-8505 Fax: 208-263-2908 | |
Charles M Crane, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 423 N 3rd Ave Ste 210, Sandpoint, ID 83864 Phone: 208-263-6876 Fax: 208-263-2033 | |
Garrett Mathew Lee-strizich, MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 1215 Michigan St Ste B, Sandpoint, ID 83864 Phone: 208-269-5578 Fax: 855-538-6233 | |
Megan Dunbar Skibitsky, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 409 Church St, Sandpoint, ID 83864 Phone: 208-906-2525 Fax: 208-906-2527 | |
Scott Burgstahler, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 207 Church St, Sandpoint, ID 83864 Phone: 208-263-6876 Fax: 208-263-2033 | |
Lawrence Derbes Jr., MD Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 423 N Third Ave Ste 355, Sandpoint, ID 83864 Phone: 208-265-7070 Fax: 208-265-7071 |