| Podiatry Services Of Idaho, Pllc | |
|
229 E Logan St, Caldwell, ID 83605-4835 | |
| (208) 402-6587 | |
| (084) 026-5782 |
| Full Name | Podiatry Services Of Idaho, Pllc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 229 E Logan St, Caldwell, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588861405 | NPI | - | NPPES |
| 023111 | Medicaid | OR | |
| P00251554 | Other | OR | RAILROAD MEDICARE |
| DD5083 | Other | OR | RAILROAD MEDICARE GROUP NUMBER |
| 4540570001 | Other | OR | MEDICARE DMERC |
| 807150700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | DP00359 (Oregon) | Primary |
| Provider Name | Camille E Harris |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1538164108 PECOS PAC ID: 4789621962 Enrollment ID: I20051222000785 |
| Mailing Address | Practice Location Address |
|---|---|
| Podiatry Services Of Idaho, Pllc 1105 E Ustick Rd, Caldwell, ID 83605-6306 Ph: (208) 402-6587 | Podiatry Services Of Idaho, Pllc 229 E Logan St, Caldwell, ID 83605-4835 Ph: (208) 402-6587 |
Dr. Stanley G. Eto, D.P.M. Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 112 W Logan St, Caldwell, ID 83605 Phone: 208-459-0891 Fax: 208-459-8628 | |
Dr. Jed H Erickson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1818 S 10th Ave, Suite 250, Caldwell, ID 83605 Phone: 208-855-8588 Fax: 208-459-8628 | |
P. Roman Burk, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1818 S 10th Ave, Suite 250, Caldwell, ID 83605 Phone: 208-459-0891 Fax: 208-459-8628 | |
Dr. Camille Elizabeth Harris, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1105 E Ustick Rd, Caldwell, ID 83605 Phone: 208-463-7732 Fax: 541-889-4736 | |
Eto Podiatry Clinic Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 112 W Logan St, Caldwell, ID 83605 Phone: 208-459-0891 | |
Adam James Gerber, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1906 Fairview Ave Ste 430, Caldwell, ID 83605 Phone: 208-302-3100 Fax: 208-302-3155 |