| Landon Kelly Grange, MD | |
|
5680 W Gage St, Boise, ID 83706 | |
| (208) 773-3937 | |
| (208) 377-3937 |
| Full Name | Landon Kelly Grange |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 11 Years |
| Location | 5680 W Gage St, Boise, Idaho |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043620255 | NPI | - | NPPES |
| 1043620255 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207W00000X | Ophthalmology | M14219 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Mccall | Mccall, ID | Hospital |
| Entity Name | Grange Ophthalmology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285376558 PECOS PAC ID: 8527455377 Enrollment ID: O20220425001867 |
| Mailing Address | Practice Location Address |
|---|---|
| Landon Kelly Grange, MD 3867 Miramar St, Apartment G, La Jolla, CA 92037-1312 Ph: (208) 559-6893 | Landon Kelly Grange, MD 5680 W Gage St, Boise, ID 83706 Ph: (208) 773-3937 |
Dr. Mark J Boerner, M.D. Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 111 W Main St Ste 200, Boise, ID 83702 Phone: 208-344-3220 Fax: 208-344-0461 | |
James R Swartley, MD Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 222 N 2nd St, Suite 215, Boise, ID 83702 Phone: 208-342-2706 | |
Ms. Denise Elizabeth Capps, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 5680 W Gage St, Boise, ID 83706 Phone: 208-377-3937 | |
Wyatt Messenger, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 360 E Mallard Dr Ste 110, Boise, ID 83706 Phone: 206-336-8700 | |
Dr. Chad Harman Jackson, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 111 W Main St Ste 200, Boise, ID 83702 Phone: 208-344-3220 Fax: 208-344-0461 | |
Matthew D Neale, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 8955 W Hackamore Dr, Boise, ID 83709 Phone: 208-344-7944 Fax: 208-639-9360 |