| Roger Wyatt, MD | |
|
315 E Elm St, Ste 100, Caldwell, ID 83605 | |
| (208) 302-7100 | |
| (208) 302-7155 |
| Full Name | Roger Wyatt |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 315 E Elm St, Caldwell, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326305004 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | R73187 (Arizona) | Secondary |
| 207Q00000X | Family Medicine | M-12951 (Idaho) | Primary |
| Entity Name | Direct Doctor Care Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871112094 PECOS PAC ID: 2264863281 Enrollment ID: O20200507001024 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger Wyatt, MD 3340 E Goldstone Way, Meridian, ID 83642-1026 Ph: (208) 302-7100 | Roger Wyatt, MD 315 E Elm St, Ste 100, Caldwell, ID 83605 Ph: (208) 302-7100 |
Stacy Jane Lamers, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 E Elm St Ste 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Zachary A Leckenby, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 | |
Megan A Schwehr, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 808 Cleveland Blvd, Caldwell, ID 83605 Phone: 208-459-1025 Fax: 208-466-5359 | |
Miss J'cinda J'nae Bitters, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605 Phone: 208-459-4667 Fax: 208-459-3372 | |
Zechariah Wilson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 Fax: 208-375-2217 | |
Graceful Iris Morris, FNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 712 Aviation Way, Caldwell, ID 83605 Phone: 208-302-7500 Fax: 208-302-7555 | |
Jessica D Blancett, DO Family Medicine Medicare: Medicare Enrolled Practice Location: 315 E Elm St # 201, Caldwell, ID 83605 Phone: 208-514-2528 |