| Richard J Martin, MD | |
|
4400 E Flamingo, Ste 200, Nampa, ID 83687 | |
| (208) 302-2700 | |
| (208) 302-2725 |
| Full Name | Richard J Martin |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 4400 E Flamingo, Nampa, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285698571 | NPI | - | NPPES |
| 805719700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | M-7952 (Idaho) | Primary |
| Entity Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J Martin, MD 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 302-2700 | Richard J Martin, MD 4400 E Flamingo, Ste 200, Nampa, ID 83687 Ph: (208) 302-2700 |
Matthew J. Wood, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1512 12th Ave Rd, Nampa, ID 83686 Phone: 208-463-5029 | |
Dennis Weiler, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 3918 Chicago St, Nampa, ID 83686 Phone: 208-467-5155 | |
Dr. Forrest R Fredline, DO Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Christian P Vetsch, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 215 E Hawaii Ave, Nampa, ID 83686 Phone: 208-463-3141 Fax: 208-463-3044 | |
Michael A Nizzi, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 | |
Katherine Homer, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 4400 E Flamingo Ave Ste 200, Nampa, ID 83687 Phone: 208-302-2700 Fax: 208-302-2725 |