Jeffrey B Fowler (NPI# 1093777856, PAC ID# 6103018429) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY PRACTICE.
| Nation Provider ID (NPI) | 1093777856 |
| PAC ID by PECOS | 6103018429 |
| Professional Enrollment ID | I20101005000959 |
| Full Name | Jeffrey B Fowler |
| Organization Legal Name | BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC. |
| Address |
6509 Hwy 2 101 Priest River ID 83856-6609 |
| Phone Number | 2084482321 |
| Gender | M |
| Graduation Year | 1979 |
| Primary Specialty | FAMILY PRACTICE |
| Group Practice PAC ID | 2264341221 |
| Number of Group Practice Members | 15 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131328 | BONNER GENERAL HOSPITAL |
| 501310 | NEWPORT COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 6615 Comanche Ct, Bonners Ferry, ID 83805-7523 | 2082671718 | BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC. |
| 6509 Hwy 2 101, Priest River, ID 83856-6609 | 2084482321 | BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC. |
| Organization Legal Name | BOUNDARY REGIONAL COMMUNITY HEALTH CENTER, INC. |
| Physicians | 21 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mallorie Ely | Clinical Social Worker | Boundary Regional Community Health Center, Inc. | 420 N 2nd Ave, Suite 100, Sandpoint, ID 83864-1552 |
| Daniel C Barry | Physician Assistant | Boundary Regional Community Health Center, Inc. | 6615 Comanche St, Bonners Ferry, ID 83805-7523 |
| Albert K Jabbour | Physician Assistant | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2, Suite 101, Priest River, ID 83856-6609 |
| George V Deland | Pediatric Medicine | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2 101, Priest River, ID 83856-6609 |
| Ann Cox | Nurse Practitioner | Boundary Regional Community Health Center, Inc. | 30410 Hwy 200, Ponderay, ID 83852-9601 |
| Erin Bass | Nurse Practitioner | Boundary Regional Community Health Center, Inc. | 30410 Hwy 200, Ponderay, ID 83852-9601 |
| Gina M Beck | Clinical Social Worker | Boundary Regional Community Health Center, Inc. | 6615 Comanche St, Bonners Ferry, ID 83805-7523 |
| Stephen Christensen | Family Medicine | Boundary Regional Community Health Center, Inc. | 30410 Hwy 200, Ponderay, ID 83852-9601 |
| Celina Ruddle | Clinical Social Worker | Boundary Regional Community Health Center, Inc. | 30410 Hwy 200, Ponderay, ID 83852-9601 |
| Michael Mcisaac | Physician Assistant | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2, Suite 101, Priest River, ID 83856-6609 |
| Street Address |
6509 HWY 2 101 |
| City | PRIEST RIVER |
| State | ID |
| Zip | 83856-6609 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| George V Deland | Pediatric Medicine | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2 101, Priest River, ID 83856-6609 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Albert K Jabbour | Physician Assistant | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2, Suite 101, Priest River, ID 83856-6609 |
| Bradley Kiriaka | Chiropractic | Chiropractic Plus | 6509 Hwy 2 103, Priest River, ID 83856-6609 |
| Michael Mcisaac | Physician Assistant | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2, Suite 101, Priest River, ID 83856-6609 |
| Kendell A Simm | Physician Assistant | Boundary Regional Community Health Center, Inc. | 6509 Hwy 2, Suite 101, Priest River, ID 83856-6609 |
| City | PRIEST RIVER |
| Zip Code | 83856 |
| Specialty | FAMILY PRACTICE |
| City + Specialty | PRIEST RIVER + FAMILY PRACTICE |
Please comment or provide details below to improve the information on Jeffrey B Fowler.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.