| Jack Casteel Bruner Ii, MD | |
|
701 Lewiston St, Cottonwood, ID 83522-9750 | |
| (208) 962-3267 | |
| (208) 962-2313 |
| Full Name | Jack Casteel Bruner Ii |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 34 Years |
| Location | 701 Lewiston St, Cottonwood, 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 |
|---|---|---|---|
| 1982607669 | NPI | - | NPPES |
| 002283800 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | M6055 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | M6055 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Marys Hospital And Clinics | Cottonwood, ID | Hospital |
| St Joseph Regional Medical Center | Lewiston, ID | Hospital |
| Clearwater Valley Hospital & Clinics | Orofino, ID | Hospital |
| Grangeville Health & Rehabilitation Center | Grangeville, ID | Nursing home |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St. Mary's Hospital, Inc. | 5092773168 | 13 |
| Entity Name | St. Mary's Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841292307 PECOS PAC ID: 5092773168 Enrollment ID: O20050316000814 |
| Entity Name | St. Mary's Hospital, Inc. |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1841292307 PECOS PAC ID: 5092773168 Enrollment ID: O20061104000429 |
| Mailing Address | Practice Location Address |
|---|---|
| Jack Casteel Bruner Ii, MD Po Box 565, Cottonwood, ID 83522-0565 Ph: (208) 962-3267 | Jack Casteel Bruner Ii, MD 701 Lewiston St, Cottonwood, ID 83522-9750 Ph: (208) 962-3267 |
Alvin Jackson Secrest Iii, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3267 Fax: 208-962-2313 | |
Tema Lynn Jessup, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3251 Fax: 208-962-2313 | |
Haley J Minnehan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3267 Fax: 208-962-2313 | |
Dr. Jeremy D Ostrander, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3267 Fax: 208-962-2313 | |
Nicholas B Henrie, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3267 | |
Dr. Andrew F Jones, DO Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1775 Keuterville Road, Cottonwood, ID 83522 Phone: 208-962-3052 | |
Justin Leroy Jones, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3251 Fax: 208-962-2478 |