| Skyler S Worthington, PA-C | |
|
156 6th St, Potlatch, ID 83855 | |
| (208) 875-2380 | |
| (208) 875-2303 |
| Full Name | Skyler S Worthington |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 156 6th St, Potlatch, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992091722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-1825 (Idaho) | Primary |
| Entity Name | Gritman Medical Center Inc |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1619988144 PECOS PAC ID: 8729070164 Enrollment ID: O20040908001492 |
| Entity Name | Gritman Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477004828 PECOS PAC ID: 4981984390 Enrollment ID: O20161130002249 |
| Mailing Address | Practice Location Address |
|---|---|
| Skyler S Worthington, PA-C Po Box 8007, Moscow, ID 83843-0507 Ph: (208) 882-4511 | Skyler S Worthington, PA-C 156 6th St, Potlatch, ID 83855 Ph: (208) 875-2380 |
Mr. Michael Clyde Graham, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 225 6th St, Potlatch, ID 83855 Phone: 208-883-2220 |
Charlotte S Ainge, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 156 N. 6th St, Potlatch, ID 83855 Phone: 208-875-2380 |