| Lawrence Estel Banta, MD | |
|
1906 Fairview Ave, Suite 200, Caldwell, ID 83605-5407 | |
| (208) 459-4667 | |
| (208) 442-6520 |
| Full Name | Lawrence Estel Banta |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 48 Years |
| Location | 1906 Fairview Ave, Caldwell, 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 |
|---|---|---|---|
| 1568440295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M-5243 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Valley Medical Center | Caldwell, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Emmett Counseling And Psychiatric Services, Llc | 0749469468 | 5 |
| West Valley Medical Associates Inc | 9931467289 | 13 |
| Entity Name | Emmett Counseling And Psychiatric Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992007249 PECOS PAC ID: 0749469468 Enrollment ID: O20110127000575 |
| Entity Name | West Valley Medical Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164936720 PECOS PAC ID: 9931467289 Enrollment ID: O20171214002975 |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence Estel Banta, MD Po Box 277976, Atlanta, GA 30384-7976 Ph: () - | Lawrence Estel Banta, MD 1906 Fairview Ave, Suite 200, Caldwell, ID 83605-5407 Ph: (208) 459-4667 |
Dr. Sandra Lare, D.O. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2609 S 10th Ave Ste 102, Caldwell, ID 83605 Phone: 208-454-2766 | |
Wade Harris, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St, Ste 201, Caldwell, ID 83605 Phone: 208-454-0567 | |
Dr. Richard A. Montgomery, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave Ste 220, Caldwell, ID 83605 Phone: 208-795-5072 | |
Colt Kennington, Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave Ste 220, Caldwell, ID 83605 Phone: 208-795-5072 | |
Dr. Alfred F Brem, DO Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1906 Fairview Ave Ste 220, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-442-6520 | |
Dr. L. Mark Kimsey, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 305 E Logan St, Caldwell, ID 83605 Phone: 208-459-2840 Fax: 208-459-3012 |