| Jordan Thomas Lauby, PA-C | |
|
6615 Comanche St, Bonners Ferry, ID 83805-7523 | |
| (208) 267-1718 | |
| Not Available |
| Full Name | Jordan Thomas Lauby |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 3 Years |
| Location | 6615 Comanche St, Bonners Ferry, 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 |
|---|---|---|---|
| 1659147544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-2724 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Eden Home Health | Ponderay, ID | Home health agency |
| Boundary Community Hospital | Bonners ferry, ID | Hospital |
| Bonner General Hospital | Sandpoint, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Peacehealth Networks On Demand Llc | 1759731383 | 197 |
| Boundary Regional Community Health Center Inc | 2264341221 | 22 |
| Entity Name | Peacehealth Networks on Demand LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023582178 PECOS PAC ID: 1759731383 Enrollment ID: O20240612001355 |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Thomas Lauby, PA-C 6615 Comanche St, Bonners Ferry, ID 83805-7523 Ph: Not Available | Jordan Thomas Lauby, PA-C 6615 Comanche St, Bonners Ferry, ID 83805-7523 Ph: (208) 267-1718 |
Amanda D Horricks, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6488 Chinook St, Bonners Ferry, ID 83805 Phone: 208-267-8710 |
Dean A Chapel, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6635 Comanche St, Bonners Ferry, ID 83805 Phone: 208-267-1718 Fax: 208-267-7739 |
Van Martin Stonehocker, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6641 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3655 Fax: 208-267-3757 |
Scott Lacefield, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6641 Kaniksu St, Suite A, Bonners Ferry, ID 83805 Phone: 208-267-3655 Fax: 208-267-3757 |
Kendell Ann Simm, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6615 Comanche St, Bonners Ferry, ID 83805 Phone: 208-267-1718 Fax: 208-267-9197 |