| Capital City Family Medicine Pa | |
|
1520 W State St Ste 100 Boise ID 83702-4084 | |
| (208) 947-7700 | |
| (208) 947-7711 |
| Full Name | Capital City Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1520 W State St, Boise, Idaho |
| Authorized Official Name and Position | Liz A Frisbey (OFFICE MANAGER) |
| Authorized Official Contact | 2089477700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital City Family Medicine Pa 1520 W State St Ste 100 Boise ID 83702-4084 Ph: (208) 947-7700 | Capital City Family Medicine Pa 1520 W State St Ste 100 Boise ID 83702-4084 Ph: (208) 947-7700 |
| NPI Number | 1992731319 |
|---|---|
| Provider Enumeration Date | 06/25/2006 |
| Last Update Date | 06/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992731319 | NPI | - | NPPES |
| 8052516 | Other | ID | MEDICAID MID-LEVEL GROUP |
| 8052796 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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St Lukes Clinic - Capital City Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 W State St, Ste 100, Boise, ID 83702 Phone: 208-947-7700 |