| Pocatello Family Medicine | |
|
465 Memorial Drive Pocatello ID 83201-4008 | |
| (208) 282-4700 | |
| (208) 282-4696 |
| Full Name | Pocatello Family Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 465 Memorial Drive, Pocatello, Idaho |
| Authorized Official Name and Position | Rose Johnson (OFFICE MANAGER) |
| Authorized Official Contact | 2082824421 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pocatello Family Medicine 465 Memorial Dr Pocatello ID 83201-4008 Ph: (208) 282-4700 | Pocatello Family Medicine 465 Memorial Drive Pocatello ID 83201-4008 Ph: (208) 282-4700 |
| NPI Number | 1760739973 |
|---|---|
| Provider Enumeration Date | 08/07/2012 |
| Last Update Date | 08/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760739973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | NP-1199A (Idaho) | Primary |
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