| Senior Doc Idaho PC | |
|
4301 Garrity Blvd Ste 103 Nampa ID 83687-9222 | |
| (855) 434-7763 | |
| (949) 281-5550 |
| Full Name | Senior Doc Idaho PC |
|---|---|
| Speciality | Family Medicine |
| Location | 4301 Garrity Blvd Ste 103, Nampa, Idaho |
| Authorized Official Name and Position | John Geiss (OWNER/DOCTOR) |
| Authorized Official Contact | 8554347763 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Senior Doc Idaho PC 5 Hutton Centre Dr Ste 950 Santa Ana CA 92707-8714 Ph: (558) 434-7763 | Senior Doc Idaho PC 4301 Garrity Blvd Ste 103 Nampa ID 83687-9222 Ph: (855) 434-7763 |
| NPI Number | 1750961637 |
|---|---|
| Provider Enumeration Date | 04/13/2021 |
| Last Update Date | 01/13/2025 |
| Certification Date | 01/13/2025 |
| Medicare PECOS PAC ID | 0648689174 |
|---|---|
| Medicare Enrollment ID | O20210512002640 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750961637 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Jeffrey John Thomas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932337136 PECOS PAC ID: 7315101003 Enrollment ID: I20120608000288 |
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