| Trevor Dean Jacobson, MD | |
|
166 S 5th St, Montpelier, ID 83254-4959 | |
| (208) 847-1110 | |
| (208) 847-0228 |
| Full Name | Trevor Dean Jacobson |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 16 Years |
| Location | 166 S 5th St, Montpelier, 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 |
|---|---|---|---|
| 1366677759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-12665 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Bear Lake Memorial Hospital | Montpelier, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Bear Lake County Memorial Hospital | 5395799860 | 22 |
| Entity Name | Bear Lake County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174741441 PECOS PAC ID: 5395799860 Enrollment ID: O20071003000677 |
| Mailing Address | Practice Location Address |
|---|---|
| Trevor Dean Jacobson, MD Po Box 69, Montpelier, ID 83254-0069 Ph: (208) 847-1110 | Trevor Dean Jacobson, MD 166 S 5th St, Montpelier, ID 83254-4959 Ph: (208) 847-1110 |
Dr. Larry David Bomsta, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 467 Washington St, Montpelier, ID 83254 Phone: 208-847-0072 Fax: 208-847-0077 | |
Noall E Wolff, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 360 N 2nd St, Montpelier, ID 83254 Phone: 208-847-5834 | |
Houston Reynolds, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 164 S 5th St, Montpelier, ID 83254 Phone: 208-514-2529 | |
Lance A Hansen, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Washington St, Montpelier, ID 83254 Phone: 208-847-4495 Fax: 208-847-4336 | |
Dr. Peter Melvin Crane, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 465 Washington St, Montpelier, ID 83254 Phone: 208-847-4495 | |
Khristina Ashley Meissner, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 166 S 5th St, Montpelier, ID 83254 Phone: 208-847-1110 |