Dan S Fairman (NPI# 1023059250, PAC ID# 3274618947) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1023059250 |
| PAC ID by PECOS | 3274618947 |
| Professional Enrollment ID | I20080306000137 |
| Full Name | Dan S Fairman |
| Organization Legal Name | ST LUKES CLINIC - WOOD RIVER LLC |
| Address |
100 Hospital Dr Ketchum ID 83340-9998 |
| Gender | M |
| Medical School | SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3173783818 |
| Number of Group Practice Members | 47 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131323 | ST LUKE'S WOOD RIVER MEDICAL CENTER |
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130002 | ST LUKES MAGIC VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 100 Hospital Dr, Ketchum, ID 83340-9998 | ST LUKES CLINIC - WOOD RIVER LLC | |
| 191 5th St W, Ketchum, ID 83340-9998 | 2087252171 | ST LUKES CLINIC - WOOD RIVER LLC |
| Organization Legal Name | ST LUKES CLINIC - WOOD RIVER LLC |
| Physicians | 54 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ricardo Delgado | Internal Medicine | St Lukes Clinic - Wood River LLC | 191 W 5th St, Slc Sun Valley Sports Medicine, Ketchum, ID 83340 |
| Amy C Drumm | Family Medicine | St Lukes Clinic - Wood River LLC | 191 5th St W, Ketchum, ID 83340-9998 |
| Cortney A Vandenburgh | Family Medicine | St Lukes Clinic - Wood River LLC | 1450 Aviation Dr, Hailey, ID 83333-8785 |
| Carol A Wade | Nurse Practitioner | St Lukes Clinic - Wood River LLC | 21 E Maple St, Suite A, Hailey, ID 83333-4900 |
| Frank M Batcha | Family Medicine | St Lukes Clinic - Wood River LLC | 100 Hospital Dr, Suite 201, Ketchum, ID 83340-9998 |
| Emily G Karassik | Physician Assistant | St Lukes Clinic - Wood River LLC | 1450 Aviation Dr, Hailey, ID 83333-8785 |
| Susanne Choby | Psychiatry | St Lukes Clinic - Wood River LLC | 1450 Aviation Dr, Hailey, ID 83333-8785 |
| Karin M Lindholm | Neurology | St Lukes Clinic - Wood River LLC | 1450 Aviation Dr, Hailey, ID 83333-8785 |
| Royal A Mcclure | Internal Medicine | St Lukes Clinic - Wood River LLC | 100 Hospital Dr, Ketchum, ID 83340-9998 |
| Matthew C Reeck | Dermatology | St Lukes Clinic - Wood River LLC | 100 Hospital Dr, Ketchum, ID 83340-9998 |
| Street Address |
100 HOSPITAL DR |
| City | KETCHUM |
| State | ID |
| Zip | 83340-9998 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Frank M Batcha | Family Medicine | St Lukes Clinic - Wood River LLC | 100 Hospital Dr, Suite 201, Ketchum, ID 83340-9998 |
| Quinn Mary Kneifl | Physician Assistant | Pender Community Hospital District | 100 Hospital Dr, Pender, NE 68047-4507 |
| Hassan Khalil | Internal Medicine | 100 Hospital Dr, Montrose, PA 18801-6402 | |
| Shashank Bhatt | Internal Medicine | 100 Hospital Dr, Montrose, PA 18801-6402 | |
| Ellen T Leavell | Emergency Medicine | Gem Capital Physicians Pllc | 100 Hospital Dr, Louisburg, NC 27549-2256 |
| Andrew John Krieger | Emergency Medicine | Gem Capital Physicians Pllc | 100 Hospital Dr, Louisburg, NC 27549-2256 |
| Dione E Blansit | Certified Registered Nurse Anesthetist (crna) | Mercy Clinic Springfield Communities | 100 Hospital Dr, Lebanon, MO 65536-9210 |
| Johnny R Bullock | Internal Medicine | Keystone Hospitalist Services of Ms Inc | 100 Hospital Dr, Tylertown, MS 39667-2022 |
| Vikas Sharma | Internal Medicine | Mercy Clinic Springfield Communities | 100 Hospital Dr, Lebanon, MO 65536-9210 |
| Chainarong Limvarapuss | Hematology/oncology | Solano Hematology - Oncology | 100 Hospital Dr, Suite 110, Vallejo, CA 94589-2577 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lindsey Marie Ketterling | Physical Therapy | Ieg Zenergy, LLC | 245 Raven Rd B, Ketchum, ID 83340 |
| Ricardo Delgado | Internal Medicine | St Lukes Clinic - Wood River LLC | 191 W 5th St, Slc Sun Valley Sports Medicine, Ketchum, ID 83340 |
| Thomas J West | Chiropractic | 128 Saddle Rd, Suite 100, Ketchum, ID 83340 | |
| Matthew E Kent | Optometry | 649 Sun Valley Rd, Ketchum, ID 83340 | |
| David A Mcclusky Ii | General Surgery | St Luke's Clinic LLC | 100 Hospital Dr, Suite 109, Ketchum, ID 83340 |
| Kelly P Teitzel | Certified Registered Nurse Anesthetist (crna) | St Lukes Clinic - Wood River LLC | 100 Hospital Dr, Suite 109, Ketchum, ID 83340 |
| Karoline A Droege | Physical Therapy | Ieg Zenergy, LLC | 245 Raven Rd B, Ketchum, ID 83340 |
| Colleen A Coyne | Physical Therapy | Ieg Zenergy, LLC | 245 Raven Rd B, Ketchum, ID 83340 |
| Kyle M Sela | Physical Therapy | Ieg Zenergy, LLC | 245 Raven Rd B, Ketchum, ID 83340 |
| Anthony Maisin Buoncristiani | Orthopedic Surgery | 100 Hospital Dr, Suite 107, Ketchum, ID 83340 | |
| Find all physicians in zip 83340 | |||
| City | KETCHUM |
| Zip Code | 83340 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | KETCHUM + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Dan S Fairman.
| 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.