| Lon Miguel Egbert, PT, ATC | |
|
128 5th Ave W, Jerome, ID 83338-1863 | |
| (208) 324-3090 | |
| (208) 324-3093 |
| Full Name | Lon Miguel Egbert |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 29 Years |
| Location | 128 5th Ave W, Jerome, 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 |
|---|---|---|---|
| 1437130952 | NPI | - | NPPES |
| T6962 | Other | ID | BLUE CROSS |
| 000010140741 | Other | ID | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PT1686 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Lon M. Egbert, P.c. | 8224132477 | 3 |
| Provider Name | Lon M. Egbert, P.c. |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1265527725 PECOS PAC ID: 8224132477 Enrollment ID: O20070328000656 |
| Mailing Address | Practice Location Address |
|---|---|
| Lon Miguel Egbert, PT, ATC 3121 Eagle Ridge Dr, Wendell, ID 83355-3340 Ph: (208) 536-2135 | Lon Miguel Egbert, PT, ATC 128 5th Ave W, Jerome, ID 83338-1863 Ph: (208) 324-3090 |
Dr. Daryl Dean Mayes, P.T., D.P.T., M.H.S. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1976 S Lincoln Ave, Suite 6a, Jerome, ID 83338 Phone: 208-644-1433 Fax: 208-644-1434 | |
Ms. Donna Starodoj Alfs, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 128 5th Ave W, Jerome, ID 83338 Phone: 208-324-3090 | |
Austin Cobbley, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 111 Pioneer Ct, Jerome, ID 83338 Phone: 208-944-9277 Fax: 208-944-9280 | |
Clinton Axman, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 128 5th Ave W, Jerome, ID 83338 Phone: 208-324-3090 Fax: 208-324-3093 |