| Logan Anderson, DO | |
|
132 5th Ave W Ste 1&2, Jerome, ID 83338-1871 | |
| (208) 814-9800 | |
| Not Available |
| Full Name | Logan Anderson |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 132 5th Ave W Ste 1&2, Jerome, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356916209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O-1750 (Idaho) | Primary |
| Entity Name | St Lukes Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790718229 PECOS PAC ID: 1052217478 Enrollment ID: O20031208000899 |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Anderson, DO 132 5th Ave W Ste 1&2, Jerome, ID 83338-1871 Ph: (208) 814-9800 | Logan Anderson, DO 132 5th Ave W Ste 1&2, Jerome, ID 83338-1871 Ph: (208) 814-9800 |
Dr. James S Irwin, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 132 5th Ave W, Suite 1, Jerome, ID 83338 Phone: 208-814-9800 Fax: 208-814-9833 | |
Michael J Keller, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W Ste 1, Jerome, ID 83338 Phone: 208-814-9800 | |
Brian Lee Johnson, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 709 N Lincoln Ave, Jerome, ID 83338 Phone: 208-324-4301 | |
Elizabeth Hart Sugden, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W, Jerome, ID 83338 Phone: 208-324-5286 Fax: 208-324-9815 | |
Nelson S Browning, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 132 5th Ave W Ste 1, Jerome, ID 83338 Phone: 208-814-9800 | |
Dr. Joshua William Kern, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 132 5th Ave W, Suite 1, Jerome, ID 83338 Phone: 208-814-9800 Fax: 208-814-9835 |