| John Lattin, MD | |
|
4424 E Flamingo Ave, Suite 310, Nampa, ID 83687 | |
| (208) 302-3760 | |
| (208) 302-3768 |
| Full Name | John Lattin |
|---|---|
| Gender | Male |
| Speciality | Pain Management |
| Experience | 11 Years |
| Location | 4424 E Flamingo Ave, Nampa, 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 |
|---|---|---|---|
| 1477949261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | M-15324 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| Saint Alphonsus Medical Center Ontario | Ontario, OR | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | 3476462359 | 672 |
| Entity Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
| Mailing Address | Practice Location Address |
|---|---|
| John Lattin, MD 3340 E Goldstone Dr, Meridian, ID 83642 Ph: (208) 302-3760 | John Lattin, MD 4424 E Flamingo Ave, Suite 310, Nampa, ID 83687 Ph: (208) 302-3760 |
Olivia Nilda Blom, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 5251 E Exchange Way, Nampa, ID 83687 Phone: 208-466-9642 Fax: 208-466-9104 |