| Mountain View Family Medicine, Inc | |
|
2006 Birdie Thompson Dr Pocatello ID 83201-2768 | |
| (208) 232-1132 | |
| (208) 232-1134 |
| Full Name | Mountain View Family Medicine, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2006 Birdie Thompson Dr, Pocatello, Idaho |
| Authorized Official Name and Position | Bradley Mark Burton (PRESIDENT) |
| Authorized Official Contact | 2082321132 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain View Family Medicine, Inc 2006 Birdie Thompson Dr Pocatello ID 83201-2768 Ph: (208) 232-1132 | Mountain View Family Medicine, Inc 2006 Birdie Thompson Dr Pocatello ID 83201-2768 Ph: (208) 232-1132 |
| NPI Number | 1053483669 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 3274592159 |
|---|---|
| Medicare Enrollment ID | O20041006000945 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053483669 | NPI | - | NPPES |
| 1373873 | Other | ID | MEDICARE |
| 86428200 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Idaho) | Primary |
| Provider Name | Bradley M Burton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093818239 PECOS PAC ID: 7719946698 Enrollment ID: I20050427000674 |
| Provider Name | Earl E Holmstead |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790870400 PECOS PAC ID: 3678501616 Enrollment ID: I20050801000098 |
| Provider Name | Kyle L Clifford |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1841285590 PECOS PAC ID: 1254405871 Enrollment ID: I20080730000858 |
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