| Family Medical Clinic Of Chubbuck | |
|
476 E Chubbuck Rd Pocatello ID 83202-1816 | |
| (208) 233-9898 | |
| (208) 232-8566 |
| Full Name | Family Medical Clinic Of Chubbuck |
|---|---|
| Speciality | Clinic/Center |
| Location | 476 E Chubbuck Rd, Pocatello, Idaho |
| Authorized Official Name and Position | Scott Robert Barlow (OWNER) |
| Authorized Official Contact | 2082516955 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Clinic Of Chubbuck 476 E Chubbuck Rd Pocatello ID 83202-1816 Ph: (208) 251-6955 | Family Medical Clinic Of Chubbuck 476 E Chubbuck Rd Pocatello ID 83202-1816 Ph: (208) 233-9898 |
| NPI Number | 1003231911 |
|---|---|
| Provider Enumeration Date | 02/28/2014 |
| Last Update Date | 04/28/2014 |
| Medicare PECOS PAC ID | 0840414975 |
|---|---|
| Medicare Enrollment ID | O20140611002137 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003231911 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Patricia Stadler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124569108 PECOS PAC ID: 0446537526 Enrollment ID: I20170426002519 |
| Provider Name | Scott Barlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023673209 PECOS PAC ID: 8921222050 Enrollment ID: I20190730004477 |
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