Mayben Cole Johnson (NPI# 1306920202, PAC ID# 6608958277) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1306920202 |
| PAC ID by PECOS | 6608958277 |
| Professional Enrollment ID | I20080205000254 |
| Full Name | Mayben Cole Johnson |
| Organization Legal Name | M COLE JOHNSON INC |
| Address |
526 Shoup Ave W D Twin Falls ID 83301-5050 |
| Phone Number | 2087331112 |
| Gender | M |
| Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1997 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 2062549843 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130002 | ST LUKES MAGIC VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 526 Shoup Ave W D, Twin Falls, ID 83301-5050 | 2087331112 | M COLE JOHNSON INC |
| Organization Legal Name | M COLE JOHNSON INC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Merrick G Reynolds | Physician Assistant | M Cole Johnson Inc | 526 Shoup Ave W D, Twin Falls, ID 83301-5050 |
| Street Address |
526 SHOUP AVE W D |
| City | TWIN FALLS |
| State | ID |
| Zip | 83301-5050 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Camille Smith | Family Medicine | 526 Shoup Ave W D, Twin Falls, ID 83301-5050 | |
| Merrick G Reynolds | Physician Assistant | M Cole Johnson Inc | 526 Shoup Ave W D, Twin Falls, ID 83301-5050 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| John L Etcheto | Physician Assistant | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Daniel M Wettstein | Podiatry | 176 Falls Ave, Suite 200, Twin Falls, ID 83301-2306 | |
| Clinton L Dille | Anesthesiology | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Benjamin W Attebury | Physician Assistant | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Johnny M Urrutia | Physician Assistant | Southern Idaho Pain Institute P.C. | 176 Falls Ave, Twin Falls, ID 83301-2306 |
| Ronald E Mcgarrigle | Anesthesiology | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Tammy L Emerson | Qualified Speech Language Pathologist | 450 Falls Ave, Twin Falls, ID 83301-2307 | |
| Todd G Hastings | Preventative Medicine | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Thomas W Dirocco | Hospitalist | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Mark J Edlund | Psychiatry | St Luke's Clinic LLC | 450 Falls Ave, Suite 202, Twin Falls, ID 83301-2307 |
| Find all physicians in zip 83301 | |||
| City | TWIN FALLS |
| Zip Code | 83301 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | TWIN FALLS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Mayben Cole Johnson.
| 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.