Michael R Flandro OD PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

ODP-702 Issued in ID

Legal business name

MICHAEL R FLANDRO OD PA

Practice address

360 S Arthur Ave
Pocatello, ID 83204-3307

Phone

(208) 232-6675

Fax

(208) 232-5800

NPI assigned

Sep 16, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael Reese Flandro, O.D.

Title

Owner/President

Phone

(208) 232-6675

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1922257823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S ARTHUR AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043307",
            "telephone_number": "208-232-6675",
            "fax_number": "208-232-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S ARTHUR AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832043307",
            "telephone_number": "208-232-6675",
            "fax_number": "208-232-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL R FLANDRO OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "FLANDRO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "REESE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "208-232-6675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "ODP-702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF IDAHO",
            "identifier": "000010015363",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD RETIREMENT BOARD",
            "identifier": "410039268",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002622900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "V2811",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colene K Meusborn, LCSW, DCSW
• Ryker Lane Meyer
• Courtney Meyers
• Michael G. Summers DDS, Ms, PA
• Michael J. Gregson, M.D., P.a.
• Michael T McHugh D.D.S., PA
• Michael T. Callaghan M.D. & Associates, P.a.
• Amber Mickelsen
• Brandon C Mickelsen, D.O.
• Jennifer Miesch, PHD

• Clinic/Center in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.