Military Health Care Provider Health Providers - IDAHO
171000000X - Military Health Care Provider
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
List of 8 registered providers with a business address in Idaho whose primary or secondary health provider taxonomy code is Military Health Care Provider, all registered as individuals.
100% Individual Providers (8)25% Female Providers (2)75% Male Providers (6)
List of Providers
| Provider Name | Type | Address | Medicare | PECOS | |
|---|---|---|---|---|---|
| JUSTIN FOWLER | Individual | 6165 W EMERALD ST BOISE, ID 83704 (208) 302-3900 | Non-Participating Provider | YES | |
| JARED GETZLAFF | Individual | 90 HOPE DR MOUNTAIN HOME AFB, ID 83648 (208) 828-7416 | Non-Participating Provider | YES | |
| NORMAN REYNOLDS HURST | Individual | 90 HOPE DR MOUNTAIN HOME AFB, ID 83648 (208) 828-7401 | Non-Participating Provider | YES | |
| SHANE NATHANIEL MCCAULEY | Individual | 6051 W EMERALD ST BOISE, ID 83704 (208) 302-7600 | Non-Participating Provider | YES | |
| ALEXANDER LAWRENCE REYNOLDS | Individual | 3399 E LOUISE DR STE 100 MERIDIAN, ID 83642 (208) 887-6813 | Accepts Medicare | YES | |
| NIKKI RYAN SANTIAGO | Individual | 2273 E GALA ST STE 100 MERIDIAN, ID 83642 (208) 898-9999 | Non-Participating Provider | NO | |
| ERIK DAVID SIBBERNSEN | Individual | 3101 E STATE ST STE 2120 EAGLE, ID 83616 (208) 473-3275 | Non-Participating Provider | YES | |
| ERIN SIEBERT | Individual | 90 HOPE DR BLDG 6000 MOUNTAIN HOME AFB, ID 83648 (208) 828-7580 | Non-Participating Provider | NO |
Showing page 1 of 1. The results table displays up to 100 results per page and is sorted by last name / organization name.
Individual Female Provider | Individual Male Provider | Medical Organization
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