NPI age
19 years
Enumerated 2007-03-15
Across 13 active family medicine providers in Idaho.
10 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 000316100 | |
| 01 (ID) | 1164755104 | INDIVIDUAL NPI NUMBER |
| 01 (ID) | 1316055320 | INDIVIDUAL NPI NUMBER |
| 05 (ID) | 808464700 |
Multi-provider organization. 10 individual providers on file at this primary address.
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