| Jordan Christopher Soutas, DO | |
|
1055 N Curtis Rd, Boise, ID 83706-1309 | |
| (208) 367-2121 | |
| (706) 596-6720 |
| Full Name | Jordan Christopher Soutas |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 6 Years |
| Location | 1055 N Curtis Rd, Boise, 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 |
|---|---|---|---|
| 1730717265 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 1871388 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gem State Radiology Llp | 9335044833 | 60 |
| Intermountain Medical Imaging Llc | 7517870918 | 35 |
| Gem State Radiology Llp | 9335044833 | 60 |
| Intermountain Medical Imaging Llc | 7517870918 | 35 |
| Gem State Radiology Llp | 9335044833 | 60 |
| Entity Name | Gem State Radiology LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1083661508 PECOS PAC ID: 9335044833 Enrollment ID: O20031205000623 |
| Entity Name | Intermountain Medical Imaging LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669423679 PECOS PAC ID: 7517870918 Enrollment ID: O20090130000423 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Christopher Soutas, DO 877 W Main St Ste 603, Boise, ID 83702-6070 Ph: (208) 954-8070 | Jordan Christopher Soutas, DO 1055 N Curtis Rd, Boise, ID 83706-1309 Ph: (208) 367-2121 |
Dr. Micheal George Adondakis, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 Fax: 706-596-6720 |
Jeffrey T Seabourn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2161 |
Caroline D Sobota, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2161 |
Mr. Jesse W Spinner, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 Fax: 706-596-6720 |
Dr. Anna Willis Hudson, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-954-8070 Fax: 208-954-8073 |
Brian Lane Mcmahan, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2094 Fax: 208-381-1791 |
Craig E Leymaster, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2094 |