Idaho Physicians Clinic in Blackfoot - Rural Health
Idaho Physicians Clinic - NPI 1114907532
Idaho Physicians Clinic is a Rural Health in Blackfoot, Idaho. Idaho Physicians Clinic practices all healthcare services and medical treatments related to Rural Health. The NPI Number for Idaho Physicians Clinic is 1114907532. The last update date is 2020-08-22.
Idaho Physicians Clinic's current location address is 98 Poplar St, Blackfoot, Idaho. You can contact this provider via phone number 2087853800. The mailing address for Idaho Physicians Clinic is 98 Poplar St, Blackfoot, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Idaho Physicians Clinic |
|---|---|
| Address | 98 Poplar St, Blackfoot, Idaho |
| Phone Number | 2087853800 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Kraml Louis |
| Telephone Number | 2087853804 |
NPI Number Detail
| NPI Number | 1114907532 |
|---|---|
| Provider Enumeration Date | 2006-01-20 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 98 Poplar St |
|---|---|
| City | Blackfoot |
| State | Idaho (ID) |
| Post Code | 832211758 |
| Phone Number | 2087853800 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Rural Health |
|---|---|
| Taxonomy | 261Qr1300X |
| Licence No | 36 |
|
Definition: Provides primary care and preventive health services in rural medically underserved areas. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8F496 | ID | BLUE CROSS PROVIDER # | |
| 10137702 | ID | BLUE SHIELD PROVIDER # |
Post Comment/ Review Below
What is the Idaho Physicians Clinic's 1114907532?
The Idaho Physicians Clinic's NPI (National Provider Identifier) Number is 1114907532. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Idaho Physicians Clinic located?
The Idaho Physicians Clinic is located at 98 Poplar St, Blackfoot, ID 832211758.
What is Idaho Physicians Clinic's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Idaho Physicians Clinic is Rural Health, and the taxonomy code that classifies this field of practice is 261Qr1300X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1114907532 to Idaho Physicians Clinic?
The Centers for Medicare & Medicaid Services originally issued the 1114907532 to Idaho Physicians Clinic on 2006-01-20.
As of what date were the details pertaining to Idaho Physicians Clinic last refreshed?
The information related to the Idaho Physicians Clinic, including its address, specialty, and other relevant details, was last updated on 2020-08-22.