|
| |
|
1995 E 17th St Ste A Idaho Falls ID 83404-6493 | |
| (208) 522-7666 | |
| (208) 524-2821 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 1995 E 17th St Ste A, Idaho Falls, Idaho |
| Authorized Official Name and Position | Shane G Machen (OWNER) |
| Authorized Official Contact | 2085227666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1995 E 17th St Ste A Idaho Falls ID 83404-6493 Ph: (208) 522-7666 | 1995 E 17th St Ste A Idaho Falls ID 83404-6493 Ph: (208) 522-7666 |
| NPI Number | 1013204445 |
|---|---|
| Provider Enumeration Date | 07/06/2011 |
| Last Update Date | 04/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013204445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O-0611 (Idaho) | Primary |
Physician Skin Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 730 S Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-542-9111 | |
Family First Medical Center, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3614 Washington Pkwy, Idaho Falls, ID 83404 Phone: 208-552-7700 Fax: 208-552-1783 | |
Neville Spinal Balance Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2145 West Broadway Street, Idaho Falls, ID 83402 Phone: 208-522-3130 | |
R.k. Arbon, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2860 Channing Way, Suite 116, Idaho Falls, ID 83404 Phone: 208-529-0575 Fax: 208-528-0223 | |