Mr Mark Mitchell Roubidoux Ii, | |
201 18th Ave, Lewiston, ID 83501-2768 | |
(208) 305-3537 | |
Not Available |
Full Name | Mr Mark Mitchell Roubidoux Ii |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 5 Years |
Location | 201 18th Ave, Lewiston, 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 |
---|---|---|---|
1629685235 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LA2100X | Nurse Practitioner - Acute Care | 39235 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Gritman Medical Center | Moscow, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Gritman Medical Center Inc | 0941545784 | 18 |
Gritman Medical Center Inc | 0941545784 | 18 |
Entity Name | Wa Pacs 2 Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1144706532 PECOS PAC ID: 6901156538 Enrollment ID: O20180831002235 |
Mailing Address | Practice Location Address |
---|---|
Mr Mark Mitchell Roubidoux Ii, 201 18th Ave, Lewiston, ID 83501-2768 Ph: (208) 305-3537 | Mr Mark Mitchell Roubidoux Ii, 201 18th Ave, Lewiston, ID 83501-2768 Ph: (208) 305-3537 |
Mrs. Nicole M Engledow, ARPN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 500 8th Ave, Lewiston, ID 83501 Phone: 208-792-2685 Fax: 208-792-2882 | |
Susan P Stutzman, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 215 10th St, Lewiston, ID 83501 Phone: 208-799-3100 Fax: 208-799-0349 | |
Anita Ringering, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 336 Warner Dr, Ste 4, Lewiston, ID 83501 Phone: 208-413-3835 | |
Robert Scott Mahal, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2315 8th St, Lewiston, ID 83501 Phone: 208-746-1383 Fax: 208-746-6348 | |
Spencer Godfrey, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1203 Idaho St, Lewiston, ID 83501 Phone: 208-848-8300 | |
Tracy Streibick Flynn, FNP, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1203 Idaho St, Lewiston, ID 83501 Phone: 208-848-8300 | |
Tayler Lyndsey Holman, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3428 5th St, Lewiston, ID 83501 Phone: 509-552-6674 |