| Dr Matthew H Packham, MD | |
|
801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301-5810 | |
| (208) 814-8500 | |
| (208) 734-4143 |
| Full Name | Dr Matthew H Packham |
|---|---|
| Gender | Male |
| Speciality | Obstetrics/gynecology |
| Experience | 24 Years |
| Location | 801 Pole Line Rd W, Twin Falls, 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 |
|---|---|---|---|
| 1578502589 | NPI | - | NPPES |
| 808416400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | M10701 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic Llc | 1052217478 | 294 |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Matthew H Packham, MD Po Box 587, Twin Falls, ID 83303-0587 Ph: (208) 814-7400 | Dr Matthew H Packham, MD 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301-5810 Ph: (208) 814-8500 |
Dr. Michael J Cannon, DO Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W Ste 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-933-9635 | |
Bradley Meyer, Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-8500 | |
David C Allen, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-734-4143 | |
Laura M Fall, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-814-8596 | |
Dr. Susan M Marzolf, M.D. Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W Ste 3880, Twin Falls, ID 83301 Phone: 208-814-8500 | |
Darren W Coleman, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Suite 3880, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-734-4143 |