| Richard M Maynard, DO | |
|
110 Vista Dr, Pocatello, ID 83201-5824 | |
| (208) 234-2300 | |
| (208) 234-0026 |
| Full Name | Richard M Maynard |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 38 Years |
| Location | 110 Vista Dr, Pocatello, 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 |
|---|---|---|---|
| 1952395063 | NPI | - | NPPES |
| 002665300 | Medicaid | ID | |
| DV104 | Other | ID | BLUE CROSS PROVIDER NUMBE |
| 080179525 | Other | ID | RAILROAD MEDICARE NUMBER |
| 000010003340 | Other | ID | BLUE SHIELD PROVIDER NUMB |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O-93 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Encompass Health Home Health Of Eastern Idaho | Idaho falls, ID | Home health agency |
| Lost Rivers Medical Center | Arco, ID | Hospital |
| Portneuf Medical Center | Pocatello, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Primary Care Specialists Pa | 4082699574 | 5 |
| Entity Name | Primary Care Specialists Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1508875881 PECOS PAC ID: 4082699574 Enrollment ID: O20210323002420 |
| Entity Name | Pcs Procedure Suite Llc |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1659029411 PECOS PAC ID: 6608254115 Enrollment ID: O20220610001999 |
| Mailing Address | Practice Location Address |
|---|---|
| Richard M Maynard, DO 110 Vista Dr, Pocatello, ID 83201-5824 Ph: (208) 234-2300 | Richard M Maynard, DO 110 Vista Dr, Pocatello, ID 83201-5824 Ph: (208) 234-2300 |
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 |