| Matthew J Fackrell, DO | |
|
1441 Parkway Dr, Blackfoot, ID 83221-1667 | |
| (208) 785-2600 | |
| (208) 785-8185 |
| Full Name | Matthew J Fackrell |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 21 Years |
| Location | 1441 Parkway Dr, Blackfoot, 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 |
|---|---|---|---|
| 1215968045 | NPI | - | NPPES |
| 1374716 | Other | ID | PTAN |
| 807815500 | Medicaid | ID |
| Facility Name | Location | Facility Type |
|---|---|---|
| Alliance Home Health Care | Idaho falls, ID | Home health agency |
| Alliance Hospice Of Idaho | Idaho falls, ID | Hospice |
| Mountain View Hospital | Idaho falls, ID | Hospital |
| Bingham Memorial Hospital | Blackfoot, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mountain View Hospital Llc | 4486562774 | 248 |
| Mvh Bmc Llc | 2961791991 | 14 |
| Entity Name | Mountain View Hospital Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343 |
| Entity Name | Mvh Bmc Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649699174 PECOS PAC ID: 2961791991 Enrollment ID: O20160608002399 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew J Fackrell, DO 1441 Parkway Dr, Blackfoot, ID 83221-1667 Ph: (208) 785-2600 | Matthew J Fackrell, DO 1441 Parkway Dr, Blackfoot, ID 83221-1667 Ph: (208) 785-2600 |
Peggy Toro, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 W Idaho St, Blackfoot, ID 83221 Phone: 208-782-3990 Fax: 208-782-3994 | |
Shad T Bateman, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-782-2980 Fax: 208-785-3504 | |
Dr. Amador Ramirez Cantu, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 354 S 1000 W, Blackfoot, ID 83221 Phone: 208-684-4958 | |
Gary W Soucie, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
George G Hales, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Brian Carrigan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 326 Poplar St, Blackfoot, ID 83221 Phone: 208-785-5801 Fax: 208-785-3504 |