NPI age
19 years
Enumerated 2006-08-17
Across 1691 active family medicine providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 804078800 | |
| 01 | 842188 | FIRST HEALTH |
| 01 (ID) | 000010003316 | REGENCE BLUE SHIELD |
| 01 (UT) | 32287 | DESERT MUTUAL BENEFIT |
| 01 (ID) | 52118 | BLUE CROSS |
| 01 | 870566919004 | TRICARE |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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