Blackfoot Medical Clinic, Inc | |
114 S Main St Firth ID 83236 | |
(208) 346-6614 | |
Not Available |
Full Name | Blackfoot Medical Clinic, Inc |
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Speciality | Family Medicine |
Location | 114 S Main St, Firth, Idaho |
Authorized Official Name and Position | Sheila Tibbitts (ADMINISTRATOR) |
Authorized Official Contact | 2087852600 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Blackfoot Medical Clinic, Inc 114 S Main St Firth ID 83236 Ph: () - | Blackfoot Medical Clinic, Inc 114 S Main St Firth ID 83236 Ph: (208) 346-6614 |
NPI Number | 1275633208 |
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Provider Enumeration Date | 09/22/2006 |
Last Update Date | 06/05/2008 |
Identifier | Type | State | Issuer |
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1275633208 | NPI | - | NPPES |
806884200 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |