| Lorraine Tangen M.d. Pllc | |
|
1100 N Lincoln Ave Jerome ID 83338-1856 | |
| (208) 324-6656 | |
| Not Available |
| Full Name | Lorraine Tangen M.d. Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 1100 N Lincoln Ave, Jerome, Idaho |
| Authorized Official Name and Position | Lorraine Tangen (PHYSICIAN) |
| Authorized Official Contact | 2083246656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lorraine Tangen M.d. Pllc 1100 N Lincoln Ave Jerome ID 83338-1856 Ph: (208) 324-4825 | Lorraine Tangen M.d. Pllc 1100 N Lincoln Ave Jerome ID 83338-1856 Ph: (208) 324-6656 |
| NPI Number | 1457700395 |
|---|---|
| Provider Enumeration Date | 06/10/2016 |
| Last Update Date | 06/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457700395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | M 6344 (Idaho) | Primary |
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