| Mark Pruitt, DO | |
|
6640 Kaniksu St, Bonners Ferry, ID 83805 | |
| (208) 267-3141 | |
| Not Available |
| Full Name | Mark Pruitt |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 12 Years |
| Location | 6640 Kaniksu St, Bonners Ferry, 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 |
|---|---|---|---|
| 1124432943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | O-1105 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Boundary Community Hospital | Bonners ferry, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Boundary Community Hospital | 3274583406 | 29 |
| Entity Name | Boundary Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801896683 PECOS PAC ID: 3274583406 Enrollment ID: O20050126000312 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Pruitt, DO 6640 Kaniksu St, Bonners Ferry, ID 83805-7532 Ph: (208) 267-3141 | Mark Pruitt, DO 6640 Kaniksu St, Bonners Ferry, ID 83805 Ph: (208) 267-3141 |
Matthew Wallace Johnson, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3141 | |
Robert Yost, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6640 Kaniksu St, Boundar Community Hospital, Bonners Ferry, ID 83805 Phone: 208-267-3141 | |
William Lamont Worden, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3141 Fax: 208-267-2202 | |
Dr. Jackson Joseph Bell, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3141 Fax: 208-267-4838 | |
Stuart Kendall Willis Iii, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-4850 Fax: 208-267-2202 | |
Dr. Kenton Bing-hock Goh, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3141 Fax: 208-267-2202 |