TAMARACK EAGLE MEDICAL NPI 1255621835

NPI Information

  • NPI: 1255621835
  • Provider Name: TAMARACK EAGLE MEDICAL
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • Doing Business As: TAMARACK MEDICAL & DENTAL CLINIC
  • Address: 311 VILLAGE DR
    TAMARACK, ID
    ZIP 83615
  • Phone: (208) 724-7420

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NPI Details

TAMARACK EAGLE MEDICAL is a general practice in Tamarack, ID. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee TAMARACK EAGLE MEDICAL NPI is 1255621835. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Tamarack Medical & Dental Clinic.

The provider's business location address is:

311 VILLAGE DR
TAMARACK, ID
ZIP 83615-014
Phone: (208) 724-7420

The provider's authorized official is Rourke Yeakley .
The authorized official title is Sole Member and has the following contact phone number (208) 724-7420.

The enumeration date for this NPI number is 4/15/2011 and was last updated on 4/15/2011.

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
1122300000XDentistNo
2208D00000XGeneral PracticeM8190IDAHOYes

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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