| Eagle Pediatrics | |
|
125 N. Stierman Suite A Eagle ID 83616-5136 | |
| (208) 939-4880 | |
| (208) 939-5003 |
| Full Name | Eagle Pediatrics |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 125 N. Stierman, Eagle, Idaho |
| Authorized Official Name and Position | Alan P Miller (OWNER) |
| Authorized Official Contact | 2089394880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Pediatrics 125 N. Stierman Way Suite A Eagle ID 83616-0000 Ph: (208) 939-4880 | Eagle Pediatrics 125 N. Stierman Suite A Eagle ID 83616-5136 Ph: (208) 939-4880 |
| NPI Number | 1447475918 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447475918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | M6036 (Idaho) | Primary |
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