| Ronald V Dorn Iii, MD | |
|
1055 N Curtis Road, Boise, ID 83706 | |
| (208) 367-3131 | |
| (208) 367-4860 |
| Full Name | Ronald V Dorn Iii |
|---|---|
| Gender | Male |
| Speciality | Radiology - Radiation Oncology |
| Location | 1055 N Curtis Road, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780790279 | NPI | - | NPPES |
| 004085400 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | M4653 (Idaho) | Primary |
| Entity Name | St Lukes Clinic-treasure Valley Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326336058 PECOS PAC ID: 4981878402 Enrollment ID: O20111119000045 |
| Mailing Address | Practice Location Address |
|---|---|
| Ronald V Dorn Iii, MD 3340 E Goldstone Way, Meridian, ID 83642 Ph: (208) 367-3131 | Ronald V Dorn Iii, MD 1055 N Curtis Road, Boise, ID 83706 Ph: (208) 367-3131 |
Dr. Micheal George Adondakis, MD Radiology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 Fax: 706-596-6720 | |
Jeffrey T Seabourn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2161 | |
Caroline D Sobota, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2161 | |
Mr. Jesse W Spinner, MD Radiology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 Fax: 706-596-6720 | |
Dr. Anna Willis Hudson, MD Radiology Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-954-8070 Fax: 208-954-8073 | |
Brian Lane Mcmahan, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2094 Fax: 208-381-1791 | |
Craig E Leymaster, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2094 |