| Tanner D Mitton, PA-C | |
|
1355 Parkway Dr Ste A, Blackfoot, ID 83221-1656 | |
| (986) 275-0003 | |
| (986) 275-0005 |
| Full Name | Tanner D Mitton |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 14 Years |
| Location | 1355 Parkway Dr Ste A, Blackfoot, 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 |
|---|---|---|---|
| 1144601865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | PA-1262 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Portneuf Medical Center | Pocatello, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wray Dermatology | 8921541277 | 3 |
| Pocatello Health Services Llc | 6608927637 | 178 |
| Gregory M Ford Md Pllc | 8921225483 | 3 |
| Mailing Address | Practice Location Address |
|---|---|
| Tanner D Mitton, PA-C 1355 Parkway Dr Ste A, Blackfoot, ID 83221-1656 Ph: (986) 275-0003 | Tanner D Mitton, PA-C 1355 Parkway Dr Ste A, Blackfoot, ID 83221-1656 Ph: (986) 275-0003 |
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 | |
Scott Ryan Mangum, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 98 Poplar St, Blackfoot, ID 83221 Phone: 208-785-4100 | |
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 |