Katherine Lea Mcdonough, DO | |
10717 W State Street, Star, ID 83669 | |
(208) 302-6300 | |
(208) 302-6355 |
Full Name | Katherine Lea Mcdonough |
---|---|
Gender | Female |
Speciality | Family Medicine |
Location | 10717 W State Street, Star, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649589664 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | DO172063 (Oregon) | Secondary |
207Q00000X | Family Medicine | O-1059 (Idaho) | Primary |
Entity Name | Saint Alphonsus Regional Medical Center Inc |
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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 |
---|---|
Katherine Lea Mcdonough, DO 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 302-6300 | Katherine Lea Mcdonough, DO 10717 W State Street, Star, ID 83669 Ph: (208) 302-6300 |
Nathan R. Mason, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 10717 W State St, Star, ID 83669 Phone: 208-302-6300 Fax: 208-302-6355 | |
Derek Kohlhase, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 10717 W State St, Star, ID 83669 Phone: 208-302-6300 Fax: 208-302-6355 | |
Dr. Thomas Richard Young Iii, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 4815 N High Country Way, Star, ID 83669 Phone: 208-761-6884 |