| Earl Anthony Gage, MD | |
|
100 E Idaho Street, Suite 303, Boise, ID 83712-6269 | |
| (314) 251-4772 | |
| (314) 251-5772 |
| Full Name | Earl Anthony Gage |
|---|---|
| Gender | Male |
| Speciality | Plastic Surgery |
| Location | 100 E Idaho Street, Suite 303, 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 |
|---|---|---|---|
| 1134302433 | NPI | - | NPPES |
| 1134302433 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208200000X | Plastic Surgery | 2012011130 (Missouri) | Secondary |
| 208200000X | Plastic Surgery | M-17141 (Idaho) | Primary |
| Entity Name | Idaho Cleft And Craniofacial Pediatric Plastic Surgery Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184899973 PECOS PAC ID: 3779744503 Enrollment ID: O20120423000050 |
| Mailing Address | Practice Location Address |
|---|---|
| Earl Anthony Gage, MD 100 E Idaho Street, Suite 303, Boise, ID 83712-6269 Ph: (208) 433-1736 | Earl Anthony Gage, MD 100 E Idaho Street, Suite 303, Boise, ID 83712-6269 Ph: (314) 251-4772 |
Dr. Jonathan D Kramer, M.D. Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 100 E Idaho St, Suite 301, Boise, ID 83712 Phone: 208-344-4900 Fax: 208-385-7811 | |
Dr. Sumiko Joan Hegstad, MD Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 222 N 2nd St Ste 102, Boise, ID 83702 Phone: 208-344-1281 Fax: 208-344-1696 | |
Mary Rose Fay Standlee, CSFA Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 305 E Jefferson St, Boise, ID 83712 Phone: 208-381-2222 | |
Dr. Dean Sorensen, M.D. Plastic Surgery Medicare: Not Enrolled in Medicare Practice Location: 250 Bobwhite Ct, 275, Boise, ID 83706 Phone: 208-333-0200 Fax: 208-333-0399 | |
Dinu Mistry Wolf, MD Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 341 E Bannock St, Boise, ID 83712 Phone: 208-342-8180 |