| Scott Ryan Mangum, PA-C | |
|
98 Poplar St, Blackfoot, ID 83221-1799 | |
| (208) 785-4100 | |
| Not Available |
| Full Name | Scott Ryan Mangum |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 98 Poplar St, Blackfoot, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043180730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 7371782 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Scott Ryan Mangum, PA-C 98 Poplar St, Blackfoot, ID 83221-1799 Ph: (208) 785-4100 | Scott Ryan Mangum, PA-C 98 Poplar St, Blackfoot, ID 83221-1799 Ph: (208) 785-4100 |
John Todd Allen, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-1200 | |
Beverly Hanson, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-782-3993 Fax: 208-782-3994 | |
Shawna Marie Reynolds, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 Fax: 208-785-1762 | |
Heather Faye Grimmett, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1441 Parkway Dr, Blackfoot, ID 83221 Phone: 208-785-2600 | |
Lucas P Belford, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 700 E Alice St, Blackfoot, ID 83221 Phone: 208-785-1200 | |
Ryan Blair Killpack, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 |