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1404 Pomerelle Ave. Suite A2 Burley ID 83318-1564 | |
| (208) 878-8817 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1404 Pomerelle Ave., Burley, Idaho |
| Authorized Official Name and Position | Alan S. Nelson (PHYSICIAN/OWNER) |
| Authorized Official Contact | 2088788817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1404 Pomerelle Ave Ste A2 Burley ID 83318-2013 Ph: (208) 878-8817 | 1404 Pomerelle Ave. Suite A2 Burley ID 83318-1564 Ph: (208) 878-8817 |
| NPI Number | 1184993586 |
|---|---|
| Provider Enumeration Date | 12/14/2011 |
| Last Update Date | 12/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184993586 | NPI | - | NPPES |
| 804255700 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O143 (Idaho) | Primary |
Wayne H Blauer Md Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1501 Hiland Ave, Ste L3, Burley, ID 83318 Phone: 208-678-2283 Fax: 208-677-2483 | |
Albion Valley Health Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 West 5th Street, Burley, ID 83318 Phone: 208-312-9740 Fax: 208-678-0910 | |