| Preston Family Medicine | |
|
43 N 1st E Preston ID 83263-1325 | |
| (423) 215-6465 | |
| Not Available |
| Full Name | Preston Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 43 N 1st E, Preston, Idaho |
| Authorized Official Name and Position | Gordon Scott Bontrager (OWNER) |
| Authorized Official Contact | 4232156465 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Preston Family Medicine 43 N 1st E Preston ID 83263-1325 Ph: (423) 215-6465 | Preston Family Medicine 43 N 1st E Preston ID 83263-1325 Ph: (423) 215-6465 |
| NPI Number | 1891406112 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 03/01/2023 |
| Medicare PECOS PAC ID | 6507239845 |
|---|---|
| Medicare Enrollment ID | O20230307001343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891406112 | NPI | - | NPPES |
| 1780919829 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Gordon S Bontrager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780919829 PECOS PAC ID: 4486792769 Enrollment ID: I20201211001838 |
| Provider Name | Harper Gibbs Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932883055 PECOS PAC ID: 5092169029 Enrollment ID: I20230926000596 |
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Fellows Chiropractic Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8 S State St, Preston, ID 83263 Phone: 208-852-2240 | |
Willow Valley Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 47 N 1st E, Preston, ID 83263 Phone: 208-852-0137 Fax: 208-852-3812 | |
Preston Drug Health Services Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 39 N 1st E, Preston, ID 83263 Phone: 208-852-1563 Fax: 208-852-1268 | |
Preston Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 45 N 1st E, Preston, ID 83263 Phone: 208-852-3755 Fax: 208-852-3774 |