| Payette Lakes Medical Clinic, Pa | |
|
211 Forest Street Mccall ID 83638 | |
| (208) 634-2225 | |
| (208) 634-7212 |
| Full Name | Payette Lakes Medical Clinic, Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 211 Forest Street, Mccall, Idaho |
| Authorized Official Name and Position | Jacqueline R. Bruns (VP - PHYSICIAN SERVICES) |
| Authorized Official Contact | 2086344061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Payette Lakes Medical Clinic, Pa Po Box 1047 Mccall ID 83638-1047 Ph: (208) 634-2225 | Payette Lakes Medical Clinic, Pa 211 Forest Street Mccall ID 83638 Ph: (208) 634-2225 |
| NPI Number | 1255462263 |
|---|---|
| Provider Enumeration Date | 03/08/2007 |
| Last Update Date | 03/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255462263 | NPI | - | NPPES |
| 8934-2 | Other | ID | BLUE CROSS |
| 000010006343 | Other | ID | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
St Lukes Mccall Ltd Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 Forest St, Mccall, ID 83638 Phone: 208-634-2225 | |
Urgent Health Care P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 212 N 3rd St, Suite B, Mccall, ID 83638 Phone: 208-315-4390 | |
Jennifer Paulson Np, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Park St, Mccall, ID 83638 Phone: 208-607-3738 Fax: 208-369-9274 |