| Richard John Lassere, MD | |
|
353 N. 4th 102, Pocatello, ID 83201 | |
| (208) 478-7900 | |
| (208) 479-7901 |
| Full Name | Richard John Lassere |
|---|---|
| Gender | Male |
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 353 N. 4th 102, Pocatello, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376639948 | NPI | - | NPPES |
| 003792800 | Medicaid | ID | |
| 49726 | Other | ID | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 9651486-1205 (Utah) | Primary |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard John Lassere, MD Po Box 27128, Salt Lake City, UT 84127-0128 Ph: (208) 251-9093 | Richard John Lassere, MD 353 N. 4th 102, Pocatello, ID 83201 Ph: (208) 478-7900 |
Shayna Larae Harding, APRN Family Medicine Medicare: Medicare Enrolled Practice Location: 1133 Call Creek Dr # A, Pocatello, ID 83201 Phone: 208-232-1000 Fax: 208-232-1006 | |
Cody E Patterson, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 151 N 4th Ave, Pocatello, ID 83201 Phone: 208-269-7147 Fax: 208-416-6522 | |
Dr. Bradley Yamashita Beaufort, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-282-4700 Fax: 208-282-4696 | |
Ryan Hudgens, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 | |
Shaylor Bringhurst, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-232-7862 | |
Dr. Sharla Clark, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1951 Bench Road, Suite B, Pocatello, ID 83201 Phone: 208-238-1000 Fax: 208-238-0009 | |
Joseph Alfred Enfonde, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 465 Memorial Dr, Pocatello, ID 83201 Phone: 208-282-3264 |