IDAHO PHYSICIANS CLINIC NPI 1114907532

NPI Information

NPI: 1114907532
Provider Name: IDAHO PHYSICIANS CLINIC
Classification: Clinic/Center - 261QR1300X
Specialization: Rural Health
Entity Type: Organization
Address: 98 POPLAR ST
BLACKFOOT, ID
ZIP 83221
Phone: (208) 785-3800

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NPI Details

IDAHO PHYSICIANS CLINIC is a rural health clinic center in Blackfoot, ID. IDAHO PHYSICIANS CLINIC NPI is 1114907532. The provider is registered as an organization entity type.

The provider's business location address is:

98 POPLAR ST
BLACKFOOT, ID
ZIP 83221-758
Phone: (208) 785-3800

The provider's authorized official is Louis Kraml .
The authorized official title is Ceo and has the following contact phone number (208) 785-3804.

The enumeration date for this NPI number is 1/20/2006 and was last updated on 8/22/2020.

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	261QR1300X	Clinic/Center	Rural Health	36	IDAHO	Yes

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
1	000010137702	OTHER	IDAHO	BLUE SHIELD PROVIDER #
2	8F496	OTHER	IDAHO	BLUE CROSS PROVIDER #

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: 3/30/2025

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