| Ernest A. Lucero, Md Pc | |
|
6641 Kaniksu St Ste B Bonners Ferry ID 83805-7532 | |
| (208) 267-2086 | |
| (208) 267-4013 |
| Full Name | Ernest A. Lucero, Md Pc |
|---|---|
| Speciality | General Practice |
| Location | 6641 Kaniksu St Ste B, Bonners Ferry, Idaho |
| Authorized Official Name and Position | Ernest Anthony Lucero (PRESIDENT) |
| Authorized Official Contact | 2082672086 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ernest A. Lucero, Md Pc 6641 Kaniksu St Ste B Po Box 898 Bonners Ferry ID 83805-7532 Ph: (208) 267-2086 | Ernest A. Lucero, Md Pc 6641 Kaniksu St Ste B Bonners Ferry ID 83805-7532 Ph: (208) 267-2086 |
| NPI Number | 1912189697 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 12/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912189697 | NPI | - | NPPES |
| DA558 | Other | BLUE CROSS OF IDAHO | |
| 000010003687 | Other | ID | BLUE SHIELD OF IDAHO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | M5577 (Idaho) | Primary |
Main Street Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6641 Kaniksu St, Suite A, Bonners Ferry, ID 83805 Phone: 208-265-3655 Fax: 208-267-3757 | |
Kaniksu Community Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6615 Comanche St, Bonners Ferry, ID 83805 Phone: 208-267-1718 Fax: 208-267-7739 | |
Cornerstone Urgent Care & Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 32 David Thompson Dr Ste A, Bonners Ferry, ID 83805 Phone: 208-267-3934 | |
Diehl Internal Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6640 Kaniksu St, Bonners Ferry, ID 83805 Phone: 540-454-1848 | |
Kootenai Tribal Health Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Circle Drive, Bonners Ferry, ID 83805 Phone: 208-267-5223 Fax: 208-267-8419 | |
Kaniksu Health Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6635 Comanche St, Bonners Ferry, ID 83805 Phone: 208-267-1718 Fax: 208-267-7739 | |
Boundary Community Clinics Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6641 Kaniksu St, Bonners Ferry, ID 83805 Phone: 208-267-3655 Fax: 208-267-3757 |