Derek B Eddie (NPI# 1346375367, PAC ID# 6709978265) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1346375367 |
| PAC ID by PECOS | 6709978265 |
| Professional Enrollment ID | I20070828001107 |
| Full Name | Derek B Eddie |
| Organization Legal Name | CC POCATELLO LLC |
| Address |
1595 Yellowstone Ave Pocatello ID 83201-4203 |
| Phone Number | 2082330032 |
| Gender | M |
| Graduation Year | 2006 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 8527353176 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130065 | MOUNTAIN VIEW HOSPITAL |
| 130028 | PORTNEUF MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1595 Yellowstone Ave, Pocatello, ID 83201-4203 | 2082330032 | CC POCATELLO LLC |
| Organization Legal Name | CC POCATELLO LLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott M Packer | Family Practice | Cc Pocatello LLC | 1595 Yellowstone Ave, Pocatello, ID 83201-4203 |
| Street Address |
1595 YELLOWSTONE AVE |
| City | POCATELLO |
| State | ID |
| Zip | 83201-4203 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Scott M Packer | Family Practice | Cc Pocatello LLC | 1595 Yellowstone Ave, Pocatello, ID 83201-4203 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Timothy A Flicker | Physical Therapy | 2839 Margo Ln, Pocatello, ID 83201-1961 | |
| Michael D Lance | Psychiatry | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Kenneth A Cogen | Nephrology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Randall J Skeem | Internal Medicine | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Martha Elizabeth Franz | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| John L Shuss | General Surgery | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Ciara C Christensen | Clinical Psychologist | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Robin L Hall | Nurse Practitioner | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Laurence L Martens | Family Practice | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Terry J Buccambuso | Diagnostic Radiology | St Luke's Clinic, LLC | 2001 Bench Rd, Pocatello, ID 83201-2033 |
| Find all physicians in zip 83201 | |||
| City | POCATELLO |
| Zip Code | 83201 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | POCATELLO + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Derek B Eddie.
| 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.