Fall Creek Skin And Health Pllc in Rexburg - Medical
Fall Creek Skin And Health Pllc - NPI 1629247093
Fall Creek Skin And Health Pllc is a Medical in Rexburg, Idaho. Fall Creek Skin And Health Pllc practices all healthcare services and medical treatments related to Medical. The NPI Number for Fall Creek Skin And Health Pllc is 1629247093. The last update date is 2018-06-26.
Fall Creek Skin And Health Pllc's current location address is Po Box 378, Rexburg, Idaho. You can contact this provider via phone number 2083592263 and fax number 2083592042. The mailing address for Fall Creek Skin And Health Pllc is Po Box 378, Rexburg, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Fall Creek Skin And Health Pllc |
|---|---|
| Address | Po Box 378, Rexburg, Idaho |
| Phone Number | 2083592263 |
| Fax Number | 2083592042 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHYSICIAN |
|---|---|
| Authorized Official Name | Bagley Gerald Brett |
| Credentials | P.A.-C. |
| Telephone Number | 2083592263 |
NPI Number Detail
| NPI Number | 1629247093 |
|---|---|
| Provider Enumeration Date | 2008-02-29 |
| Last Updated Date | 2018-06-26 |
Provider Mailing Address Detail
| Address | Po Box 378 |
|---|---|
| City | Rexburg |
| State | Idaho (ID) |
| Post Code | 834400378 |
| Phone Number | 2083592263 |
| Fax Number | 2083592042 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA-215 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 805069800 | ID | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Fall Creek Skin And Health Pllc by the Centers for Medicare & Medicaid Services (CMS)?
The Fall Creek Skin And Health Pllc has been assigned the NPI (National Provider Identifier) 1629247093. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Fall Creek Skin And Health Pllc is physically located?
The Fall Creek Skin And Health Pllc is physically situated at the following address: Po Box 378, Rexburg, ID, 834400378.
What is Fall Creek Skin And Health Pllc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Fall Creek Skin And Health Pllc's area of specialization is Medical, and the corresponding taxonomy code that categorizes this field of practice is 363Am0700X.
On what date did the Fall Creek Skin And Health Pllc receive the assignment of its 1629247093 from the Centers for Medicare & Medicaid Services?
The Fall Creek Skin And Health Pllc was issued its 1629247093 by the Centers for Medicare & Medicaid Services on 2008-02-29.
As of what date was the information regarding Fall Creek Skin And Health Pllc, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Fall Creek Skin And Health Pllc, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2018-06-26.