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FAMILY & FUNCTIONAL MEDICINE OF IDAHO PLLC NPI 1114352242


NPI Information

NPI: 1114352242
Provider Name: FAMILY & FUNCTIONAL MEDICINE OF IDAHO PLLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
450 W STATE ST
SUITE 250
EAGLE, ID
ZIP 83616
Phone: (208) 947-0925
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FAMILY & FUNCTIONAL MEDICINE OF IDAHO PLLC 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. FAMILY & FUNCTIONAL MEDICINE OF IDAHO PLLC NPI is 1114352242. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

450 W STATE ST
SUITE 250
EAGLE, ID
ZIP 83616-057
Phone: (208) 947-0925
Fax: (208) 947-0926

The provider's authorized official is Angela L House .
The authorized official title is Physician / Owner and has the following contact phone number (208) 947-0925.

The enumeration date for this NPI number is 9/9/2013 and was last updated on 9/9/2013.


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
1207Q00000XFamily Medicine0-O370IDAHOYes

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: 5/5/2024

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