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PODIATRY SERVICES OF IDAHO PLLC NPI 1588861405


NPI Information

NPI: 1588861405
Provider Name: PODIATRY SERVICES OF IDAHO, PLLC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
229 E LOGAN ST
CALDWELL, ID
ZIP 83605
Phone: (208) 402-6587
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PODIATRY SERVICES OF IDAHO, PLLC is a podiatrist in Caldwell, ID. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. PODIATRY SERVICES OF IDAHO, PLLC NPI is 1588861405. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

229 E LOGAN ST
CALDWELL, ID
ZIP 83605-835
Phone: (208) 402-6587
Fax: (084) 026-5782

The provider's authorized official is Camille Elizabeth Harris .
The authorized official title is Ceo and has the following contact phone number (208) 402-6587.

The enumeration date for this NPI number is 7/3/2007 and was last updated on 3/1/2022.


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
1213E00000XPodiatristDP00359OREGONYes

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
14540570001OTHEROREGONMEDICARE DMERC
2023111MEDICAIDOREGON
3807150700MEDICAIDIDAHO
4DD5083OTHEROREGONRAILROAD MEDICARE GROUP NUMBER
5P00251554OTHEROREGONRAILROAD 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: 4/28/2024

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