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
1261QR1300XClinic/CenterRural Health36IDAHOYes

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
1000010137702OTHERIDAHOBLUE SHIELD PROVIDER #
28F496OTHERIDAHOBLUE 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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