Shoshone Bannock Clinic Podiatry Group in Fort Hall, ID - Podiatrist

Shoshone Bannock Clinic Podiatry Group is a Podiatrist based in Fort Hall, Idaho. Shoshone Bannock Clinic Podiatry Group is licensed to practice in * (Not Available) (license number ) and their current practice location is 717 Mission Road, Fort Hall, Idaho. It can be reached at their office (for appointments etc.) via phone at (208) 238-5421.

NPI number for Shoshone Bannock Clinic Podiatry Group is 1952518946 and their current mailing address is Po Box 306, Pima Drive, Fort Hall, Idaho. Shoshone Bannock Clinic Podiatry Group does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1952518946.

Contact Information

	Shoshone Bannock Clinic Podiatry Group
	717 Mission Road, Fort Hall, ID 83203
	(208) 238-5421
	(208) 238-5462

Healthcare Provider's Profile

Full Name	Shoshone Bannock Clinic Podiatry Group
Type	Facility
Speciality	Podiatrist
Location	717 Mission Road, Fort Hall, Idaho
Accepts Medicare Assignments	Does not participate in Medicare Program. The facility may not accept medicare assignment.

NPI Data:

NPI Number: 1952518946
Provider Enumeration Date: 05/17/2007
Last Update Date: 08/22/2020

Medical Identifiers

Medical identifiers for Shoshone Bannock Clinic Podiatry Group such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1952518946	NPI	-	NPPES
8066486	Medicaid	ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
213E00000X	Podiatrist	(* (Not Available))	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shoshone Bannock Clinic Podiatry Group is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Shoshone Bannock Clinic Podiatry Group Po Box 306, Pima Drive, Fort Hall, ID 83203-0306 Ph: (208) 478-3994	Shoshone Bannock Clinic Podiatry Group 717 Mission Road, Fort Hall, ID 83203 Ph: (208) 238-5421

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Shoshone Bannock Clinic Podiatry Group - Podiatrist in Fort Hall, ID