NANCY MALLORY MD NPI 1083665129

NPI Information

  • NPI: 1083665129
  • Provider Name: NANCY MALLORY, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 435 S EAGLE RD
    EAGLE, ID
    ZIP 83616
  • Phone: (208) 939-8200

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NPI Details

Nancy Mallory, MD is a family medicine in Eagle, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Nancy Mallory, MD NPI is 1083665129. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

435 S EAGLE RD
EAGLE, ID
ZIP 83616-067
Phone: (208) 939-8200

The enumeration date for this NPI number is 5/13/2006 and was last updated on 1/23/2008.

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
1207Q00000XFamily MedicineM8876IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H74313MEDICARE UPIN
2P0026079MEDICARE PIN
31112927MEDICARE PIN

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: 11/21/2025

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