| Chuck B Fuller, PA-C | |
|
660 Shoshone St E, Suite 130, Twin Falls, ID 83301-6110 | |
| (208) 732-3400 | |
| (208) 732-3300 |
| Full Name | Chuck B Fuller |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 29 Years |
| Location | 660 Shoshone St E, Twin Falls, 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 |
|---|---|---|---|
| 1124015102 | NPI | - | NPPES |
| 000010147741 | Other | ID | REGENCE BLUE SHIELD IND # |
| PAQR4 | Other | ID | BLUE CROSS IND # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-499 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Sterling Provider Group | 2264773373 | 52 |
| Entity Name | Sterling Provider Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205300407 PECOS PAC ID: 2264773373 Enrollment ID: O20190417001724 |
| Mailing Address | Practice Location Address |
|---|---|
| Chuck B Fuller, PA-C 660 Shoshone St E, Suite 130, Twin Falls, ID 83301-6110 Ph: (208) 732-3400 | Chuck B Fuller, PA-C 660 Shoshone St E, Suite 130, Twin Falls, ID 83301-6110 Ph: (208) 732-3400 |
Ryan Dennis Hodges, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 388 Martin St, Twin Falls, ID 83301 Phone: 208-734-0451 Fax: 208-734-0452 |
Heather Mcdonald Nope, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 243 Cheney Dr W Ste 200, Twin Falls, ID 83301 Phone: 208-736-7422 |
Robert J Reeve, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1552 Addison Ave E, Ste A2, Twin Falls, ID 83301 Phone: 208-739-9961 Fax: 208-739-9962 |
Mrs. Kimberly Dolecheck Tverdy, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 775 Pole Line Rd W Ste 203, Twin Falls, ID 83301 Phone: 208-814-8300 |
John Laurent Etcheto, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 176 Falls Avenue, Twin Falls, ID 83301 Phone: 208-733-3181 Fax: 208-733-3168 |
Mindy L Brown, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Suite 3810, Twin Falls, ID 83301 Phone: 208-814-8500 Fax: 208-734-4143 |
Abelardo Benitez, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 794 Eastland Dr, Twin Falls, ID 83301 Phone: 208-734-3312 Fax: 208-734-5036 |