| Dr John Christopher Stackow, MD | |
|
1551 E Mullan Ave Ste 102, Post Falls, ID 83854-9005 | |
| (208) 262-2328 | |
| (208) 619-5057 |
| Full Name | Dr John Christopher Stackow |
|---|---|
| Gender | Male |
| Speciality | General Surgery |
| Experience | 37 Years |
| Location | 1551 E Mullan Ave Ste 102, Post 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 |
|---|---|---|---|
| 1922095397 | NPI | - | NPPES |
| 1922095397 | Medicaid | ID | |
| 1022315 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | M-6239 (Idaho) | Secondary |
| 208M00000X | Hospitalist | M-6239 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northwest Specialty Hospital | Post falls, ID | Hospital |
| Kootenai Health | Coeur d'alene, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| North Idaho Day Surgery Llc | 0840101218 | 76 |
| Entity Name | North Idaho Day Surgery Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104824739 PECOS PAC ID: 0840101218 Enrollment ID: O20110401000539 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John Christopher Stackow, MD 1593 E Polston Ave, Post Falls, ID 83854-5326 Ph: (208) 262-2300 | Dr John Christopher Stackow, MD 1551 E Mullan Ave Ste 102, Post Falls, ID 83854-9005 Ph: (208) 262-2328 |
Dr. Lorene Ann Osmanski, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1551 E Mullan Ave Ste 102, Post Falls, ID 83854 Phone: 208-262-2328 Fax: 208-619-5057 | |
Dr. Patrick Clark Marvil, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 1220 E Polston Ave, Post Falls, ID 83854 Phone: 208-773-1577 Fax: 208-773-1577 |