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PHYSICIAN CENTER A PROFESSIONAL COMPANY NPI 1508807926


NPI Information

NPI: 1508807926
Provider Name: PHYSICIAN CENTER , A PROFESSIONAL COMPANY
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
775 POLE LINE RD W
SUITES 105 & 111
TWIN FALLS, ID
ZIP 83301
Phone: (208) 814-8000
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PHYSICIAN CENTER , A PROFESSIONAL COMPANY is a family medicine in Twin Falls, 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. PHYSICIAN CENTER , A PROFESSIONAL COMPANY NPI is 1508807926. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

775 POLE LINE RD W
SUITES 105 & 111
TWIN FALLS, ID
ZIP 83301-814
Phone: (208) 814-8000
Fax: (208) 733-9402

The provider's authorized official is Mitchell J Moffitt .
The authorized official title is Physician and has the following contact phone number (208) 814-8000.

The enumeration date for this NPI number is 6/9/2006 and was last updated on 3/9/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsNo
22083X0100XPreventive MedicineOccupational MedicineNo
3207Q00000XFamily MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11374354MEDICARE ID-TYPE UNSPECIFIEDIDAHOMEDICARE NUMBER
21039210001MEDICARE NSCIDAHO
3002746900MEDICAIDIDAHO
4CD3787OTHERIDAHORR MEDICARE

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: 11/14/2023

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