| Phillip Imperio, | |
|
633 N 4th St, Boise, ID 83702-4510 | |
| (208) 342-9800 | |
| Not Available |
| Full Name | Phillip Imperio |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 633 N 4th St, Boise, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790504959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | (* (Not Available)) | Primary |
| Entity Name | Pain Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740582303 PECOS PAC ID: 0941489819 Enrollment ID: O20110124001272 |
| Mailing Address | Practice Location Address |
|---|---|
| Phillip Imperio, 633 N 4th St, Boise, ID 83702-4510 Ph: Not Available | Phillip Imperio, 633 N 4th St, Boise, ID 83702-4510 Ph: (208) 342-9800 |
Brittany Guthrie, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1072 N Liberty Street, Ste 303, Boise, ID 83704 Phone: 208-302-4400 Fax: 208-302-4255 |
Jessica Jerdin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6165 W Emerald St, Boise, ID 83704 Phone: 208-302-3900 Fax: 208-302-3955 |
Kaydon J Lloyd, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 999 N Curtis Rd Ste 415, Boise, ID 83706 Phone: 208-302-2600 Fax: 208-302-2625 |
Polina Kokoulina, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St, Ste 101, Boise, ID 83704 Phone: 208-367-5050 Fax: 208-367-5151 |
Natalie Marie Hague, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 100 E Warm Springs Ave Ste B, Boise, ID 83712 Phone: 208-381-6930 Fax: 208-381-6931 |
Micah Ray Tobin, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10583 W Lake Hazel Rd, Boise, ID 83709 Phone: 208-302-5950 Fax: 208-302-5955 |
Jason H. Mcbride, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3131 |