KODY KURTIS TEW PA-C NPI 1760724744

NPI Information

NPI: 1760724744
Provider Name: KODY KURTIS TEW, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: SIMPSON DERMCARE AND FAMILY MEDICINE PLLC

PECOS Registration: Yes

Address:
2088 E 25TH ST
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 528-7655
Get Directions

Kody Kurtis Tew, PA-C is a medical physician assistant in Idaho Falls, ID with 12 years of experience. Kody Kurtis Tew, PA-C NPI is 1760724744. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2088 E 25TH ST
IDAHO FALLS, ID
ZIP 83404-490
Phone: (208) 528-7655
Fax: (208) 524-9390

The NPI 1760724744 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/18/2013 and was last updated on 3/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA-1057	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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