| Tyler Jake Tolman, | |
|
3101 E State St Ste And2107, Eagle, ID 83616-6232 | |
| (208) 473-3500 | |
| Not Available |
| Full Name | Tyler Jake Tolman |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 7 Years |
| Location | 3101 E State St Ste And2107, Eagle, 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 |
|---|---|---|---|
| 1740774439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MRO-1739 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | O-1336 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| St Luke's Nampa Medical Center | Nampa, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic-treasure Valley Llc | 4981878402 | 1062 |
| 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 |
|---|---|
| Tyler Jake Tolman, 190 E Bannock St, Boise, ID 83712-6241 Ph: () - | Tyler Jake Tolman, 3101 E State St Ste And2107, Eagle, ID 83616-6232 Ph: (208) 473-3500 |
Mr. Peter Voss Abraham, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 507 S Fitness Pl, Suite 110, Eagle, ID 83616 Phone: 208-947-0925 Fax: 208-947-0926 | |
Bartholomew Michael Ripepi, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1895 Mcgrath Rd, Eagle, ID 83616 Phone: 208-939-8200 Fax: 208-939-8222 | |
Nancy Mallory, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 435 S Eagle Rd, Eagle, ID 83616 Phone: 208-939-8200 | |
Dr. James Donald Mcgregor, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 323 E Riverside Drive, Ste 224, Eagle, ID 83616 Phone: 208-302-6000 Fax: 208-302-6055 | |
Dr. Michael A Kaylor, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 435 S Eagle Rd, Eagle, ID 83616 Phone: 208-939-8200 Fax: 208-939-8222 | |
Dr. Jamie L Faught, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2025 E Riverside Dr Ste 160, Eagle, ID 83616 Phone: 208-900-9500 | |
David J Kelly, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3217 W Bavaria St, Eagle, ID 83616 Phone: 208-302-6200 Fax: 208-302-6255 |