MEDICARE: DR. JERROLD NEIL FLYER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	162603-1	NY

General Provider Information

NPI Number	:	1417944240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERROLD NEIL FLYER MD

Provider Business Mailing Address
First Line	:	4476 TUCK ST
Second Line	:
City	:	MOUNTAIN HOME AFB
State	:	ID
Zip	:	83648-1107
Country	:	US
Telephone Number	:	623-326-8092
Fax Number	:

Provider Business Practice Location Address
First Line	:	90 HOPE DR
Second Line	:	BUILDING 6000
City	:	MOUNTAIN HOME AFB
State	:	ID
Zip	:	83648-1057
Country	:	US
Telephone Number	:	208-828-7600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1194875286 — ALL MEDICARE HOME AIDS, INC.
Practice Location Address:

3400 SW 26TH TER , SUITE A-2
FORT LAUDERDALE, FL
33312-5068

Practice Phone: 954-791-2400
Practice Fax: 954-583-5977

1508035973 — MEDICARE HOME CARE
Practice Location Address:

8441 WAYZATA BLVD , SUITE 130
GOLDEN VALLEY, MN
55426-1344

Practice Phone: 763-546-1000
Practice Fax: 763-546-1018

1366436958 — MR. JEFFERY O'KEEFE SR. RPH
Practice Location Address:

90 HOPE DR
MTN HOME AFB, ID
83648-1057

Practice Phone: 208-828-7480
Practice Fax: 208-828-3785

1770579328 — KRISTINE MARIE HACKETT WHNP
Practice Location Address:

90 HOPE DR , 366TH MDG/SURGICAL OPERATIONS SQUADRON
MOUNTAIN HOME AFB, ID
83648-1057

Practice Phone: 208-828-7534
Practice Fax:

1669444220 — THOMAS MADDEN
Practice Location Address:

90 HOPE DR
MOUNTAIN HOME AFB, ID
83648-1057

Practice Phone: 208-828-7520
Practice Fax:

1932134350 — DR. PAULA MICHELLE NORDSTROM PH.D.
Practice Location Address:

90 HOPE DR
MOUNTAIN HOME AFB, ID
83648-1057

Practice Phone: 208-828-7139
Practice Fax:

Directions to “ DR. JERROLD NEIL FLYER MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.