Dustin G Larsen (NPI# 1699194530, PAC ID# 7719281260) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1699194530 |
| PAC ID by PECOS | 7719281260 |
| Professional Enrollment ID | I20171017002308 |
| Full Name | Dustin G Larsen |
| Organization Legal Name | NORTH IDAHO DERMATOLOGY PA |
| Address |
476394 Hwy 95 Ponderay ID 83852-5014 |
| Phone Number | 2086657546 |
| Gender | M |
| Graduation Year | 2014 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 2365404431 |
| Number of Group Practice Members | 12 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 476394 Hwy 95, Ponderay, ID 83852-5014 | 2086657546 | NORTH IDAHO DERMATOLOGY PA |
| Organization Legal Name | NORTH IDAHO DERMATOLOGY PA |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jacqueline A Guidry | Dermatology | North Idaho Dermatology Pa | 2199 N Merritt Creek Loop, Coeur D Alene, ID 83814-4949 |
| Benjamin C Ringger | Dermatology | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Shannon K Mortensen | Nurse Practitioner | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Richard A Flygare | Physician Assistant | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Craig A Rodriguez | Physician Assistant | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Stephen D Craig | Dermatology | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Hilary L Cutler | Nurse Practitioner | North Idaho Dermatology Pa | 2207 N Molter Rd, Suite 203, Liberty Lake, WA 99019-7571 |
| Hilary H Hill | Dermatology | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Jamie N Tesky | Nurse Practitioner | North Idaho Dermatology Pa | 2199 N Merritt Creek Loop, Coeur D Alene, ID 83814-4949 |
| Street Address |
476394 HWY 95 |
| City | PONDERAY |
| State | ID |
| Zip | 83852-5014 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Benjamin C Ringger | Dermatology | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Shannon K Mortensen | Nurse Practitioner | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Richard A Flygare | Physician Assistant | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Craig A Rodriguez | Physician Assistant | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Stephen D Craig | Dermatology | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Hilary H Hill | Dermatology | North Idaho Dermatology Pa | 476394 Hwy 95, Ponderay, ID 83852-5014 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bruce W Demko | Certified Registered Nurse Anesthetist (crna) | 30544 Hwy 200 201, Ponderay, ID 83852-5005 | |
| Joan M Bloom | Family Medicine | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| K Garrett Fischer | Physical Therapy | Kauai In-home Therapy LLC | 30544 Hwy 200, Ponderay, ID 83852-5005 |
| Travis L Taylor | Nurse Practitioner | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Lindsey M Ruppel | Family Medicine | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Michael R Di Benedetto | Orthopedic Surgery | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Michael D Schicker | Orthopedic Surgery | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Jonathan D Fisher | Podiatry | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Darwin L Hurst | Nurse Practitioner | Michael R Dibenedetto Md Pllc | 30544 Hwy 200, Suite 102, Ponderay, ID 83852-5005 |
| Jonathan Roy Gardunia | Physical Therapy | Kauai In-home Therapy LLC | 30544 Hwy 200, Ponderay, ID 83852-5005 |
| Find all physicians in zip 83852 | |||
| City | PONDERAY |
| Zip Code | 83852 |
| Specialty | DERMATOLOGY |
| City + Specialty | PONDERAY + DERMATOLOGY |
Please comment or provide details below to improve the information on Dustin G Larsen.
| 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.