| Todd Cranor, PA-C | |
|
1950 E Clark St Ste 110, Pocatello, ID 83201-3315 | |
| (208) 232-7246 | |
| Not Available |
| Full Name | Todd Cranor |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 1950 E Clark St Ste 110, Pocatello, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477021020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-1650 (Idaho) | Secondary |
| 363A00000X | Physician Assistant | PA56759 (California) | Primary |
| Entity Name | Mountain View Hospital LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669462362 PECOS PAC ID: 4486562774 Enrollment ID: O20040527001343 |
| Entity Name | Community Care West Side LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295009785 PECOS PAC ID: 3678738218 Enrollment ID: O20120703000554 |
| Entity Name | CC Pocatello LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538517156 PECOS PAC ID: 8527353176 Enrollment ID: O20160822003018 |
| Mailing Address | Practice Location Address |
|---|---|
| Todd Cranor, PA-C 3385 Potomac Way, Idaho Falls, ID 83404-4978 Ph: (208) 522-7246 | Todd Cranor, PA-C 1950 E Clark St Ste 110, Pocatello, ID 83201-3315 Ph: (208) 232-7246 |
Alyssa M Woodbury, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 777 Hospital Way, Pocatello, ID 83201 Phone: 208-239-1226 Fax: 208-239-3671 |
Shannon Alison Webb, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 777 Hospital Way, Pocatello, ID 83201 Phone: 208-239-1000 |
Mrs. Helena M. B. Rizor, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1448 E Center St, Pocatello, ID 83201 Phone: 208-234-1300 Fax: 208-234-1333 |
Shelby J Worthington, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1224 Palmer Ln, Pocatello, ID 83201 Phone: 208-650-0677 |
Gabrielle Abernathy, Physician Assistant Medicare: Medicare Enrolled Practice Location: 500 S 11th Ave Ste 100, Pocatello, ID 83201 Phone: 208-232-6214 |
Shad Carl Johnson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1151 Hospital Way Bldg A, Pocatello, ID 83201 Phone: 208-232-6616 Fax: 208-232-6618 |
Mr. Michael John Doyle, PA-C(PHYS ASST) Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 921 S 8th Ave Stop 8311, Pocatello, ID 83209 Phone: 208-282-2330 Fax: 208-282-4036 |