Ernest a. Lucero, MD PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

M5577 Issued in ID

Legal business name

ERNEST A. LUCERO, MD PC

Practice address

6641 Kaniksu St Ste B
Bonners Ferry, ID 83805-7532

Phone

(208) 267-2086

Fax

(208) 267-4013

NPI assigned

Dec 4, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ernest Anthony Lucero, M.D.

Title

President

Phone

(208) 267-2086

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1912189697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6641 KANIKSU ST STE B",
            "address_2": "PO BOX 898",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057532",
            "telephone_number": "208-267-2086",
            "fax_number": "208-267-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6641 KANIKSU ST STE B",
            "city": "BONNERS FERRY",
            "state": "ID",
            "postal_code": "838057532",
            "telephone_number": "208-267-2086",
            "fax_number": "208-267-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNEST A. LUCERO, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "LUCERO",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-267-2086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "ID",
            "license": "M5577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "DA558",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IDAHO",
            "identifier": "000010003687",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Susan F. Falck, LCSW
• Foster Holdings LTD
• Dana R Fox, HIS
• John Friesen, M.D.
• Angela Pearl Plaida Fusco, PHARMD

• General Practice Physician in Bonners Ferry, ID
• Providers in Bonners Ferry, ID by specialty
• General Practice Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.