| Rigby Family Medicine Llc | |
|
480 Rigby Lake Drive Rigby ID 83442-0000 | |
| (208) 745-3500 | |
| (208) 745-3501 |
| Full Name | Rigby Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 480 Rigby Lake Drive, Rigby, Idaho |
| Authorized Official Name and Position | Steven Jared Potter (OWNER/PRESIDENT) |
| Authorized Official Contact | 2087453500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rigby Family Medicine Llc 480 Rigby Lake Drive Rigby ID 83442-0000 Ph: (208) 745-3500 | Rigby Family Medicine Llc 480 Rigby Lake Drive Rigby ID 83442-0000 Ph: (208) 745-3500 |
| NPI Number | 1609499094 |
|---|---|
| Provider Enumeration Date | 05/20/2020 |
| Last Update Date | 05/20/2020 |
| Medicare PECOS PAC ID | 4486075348 |
|---|---|
| Medicare Enrollment ID | O20200601001520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609499094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Steven Jared Potter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407922446 PECOS PAC ID: 9830190222 Enrollment ID: I20200601001559 |
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