| Dr Kirk C Peterson, MD | |
|
801 Pole Line Rd W, Department Of Pathology, Twin Falls, ID 83301-5810 | |
| (208) 814-0363 | |
| (208) 814-0911 |
| Full Name | Dr Kirk C Peterson |
|---|---|
| Gender | Male |
| Speciality | Pathology |
| Experience | 30 Years |
| Location | 801 Pole Line Rd W, Twin 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 |
|---|---|---|---|
| 1982650131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZP0101X | Pathology - Anatomic Pathology | M-7970 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Lukes Magic Valley Medical Center | Twin falls, ID | Hospital |
| St Luke's Wood River Medical Center | Ketchum, ID | Hospital |
| North Canyon Medical Center | Gooding, ID | Hospital |
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Valley Pathology Associates Pllc | 0244329175 | 3 |
| Entity Name | Valley Pathology Associates Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124072798 PECOS PAC ID: 0244329175 Enrollment ID: O20071130000133 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Kirk C Peterson, MD 801 Pole Line Rd W, Department Of Pathology, Twin Falls, ID 83301-5810 Ph: () - | Dr Kirk C Peterson, MD 801 Pole Line Rd W, Department Of Pathology, Twin Falls, ID 83301-5810 Ph: (208) 814-0363 |
John B Gray, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-0364 | |
Dr. Jane Ann Bennett-munro, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 650 Addison Ave W, Twin Falls, ID 83303 Phone: 208-737-2035 | |
Michael E Gray, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-0362 |