institution
Ernest A. Lucero, Md Pc
General Practice Physician in Bonners Ferry, Idaho
NPI 1912189697

Ernest A. Lucero, Md Pc is a General Practice Physician based in Bonners Ferry, ID. Ernest A. Lucero, Md Pc practices in Bonners Ferry, ID. The NPI Number for Ernest A. Lucero, Md Pc is 1912189697 and holds a License No. M5577 (Idaho).

The current practice location address for Ernest A. Lucero, Md Pc is 6641 Kaniksu St Ste B, Bonners Ferry, ID and can be reached out via phone at 208-267-2086 and via fax at 208-267-4013.

Location: 6641 Kaniksu St Ste B, Bonners Ferry, ID, 83805-7532
institution
Provider Profile Details
NPI Number
1912189697
Provider Name
Ernest A. Lucero, Md Pc
Credential
Provider Entity Type
Organization
Address
6641 Kaniksu St Ste B, Bonners Ferry, ID, 83805-7532
Phone Number
208-267-2086
Fax Number
208-267-4013
Provider Enumeration Date
12/04/2007
Last Update Date
03/09/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
DA558 01 BLUE CROSS OF IDAHO
000010003687 01 ID BLUE SHIELD OF IDAHO
institution
Provider Business Practice Location Address Details
Address
6641 Kaniksu St Ste B
City
State
Zip
83805-7532
Phone Number
208-267-2086
Fax Number
208-267-4013
person
Provider Business Mailing Address Details
Address
6641 Kaniksu St Ste B
City
State
Zip
83805-7532
Phone Number
208-267-2086
Fax Number
208-267-4013
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
M5577 (Idaho)
Definition
Definition to come...
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