| Michael Pratt, | |
|
1501 Hiland Ave, Burley, ID 83318-2688 | |
| (208) 677-6560 | |
| Not Available |
| Full Name | Michael Pratt |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 1501 Hiland Ave, Burley, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497098891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-13206 (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 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710156922 PECOS PAC ID: 1850209420 Enrollment ID: O20040325001015 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Pratt, 1501 Hiland Ave, Burley, ID 83318-2688 Ph: () - | Michael Pratt, 1501 Hiland Ave, Burley, ID 83318-2688 Ph: (208) 677-6560 |
Mr. Ronald Bret Campbell, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1501 Hiland Ave, Suite A, Burley, ID 83318 Phone: 208-878-9432 Fax: 208-878-4576 | |
Mrs. Karrie Rae Kondel, ARNP Family Medicine Medicare: Medicare Enrolled Practice Location: 1309 Bennett Ave, Burley, ID 83318 Phone: 208-678-7796 Fax: 360-838-2450 | |
David Miller, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1309 Bennett Ave, Burley, ID 83318 Phone: 208-678-7796 Fax: 208-678-7799 | |
Dr. Stewart Raymond North, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1501 Hiland Ave, Burley, ID 83318 Phone: 208-678-4444 | |
Dr. Jeremy B Haymore, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1501 Hiland Ave, Burley, ID 83318 Phone: 208-677-6440 Fax: 208-677-6455 | |
Steven Boehmer, DO Family Medicine Medicare: May Accept Medicare Assignments Practice Location: 1335 Albion Ave, Burley, ID 83318 Phone: 208-878-2271 | |
Matthew David Detemple, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1309 Bennett Ave, Burley, ID 83318 Phone: 208-678-7796 Fax: 208-678-7799 |