DEB ELLIOTT-PEARSON M.D. P.C. NPI 1619142452

NPI Information

  • NPI: 1619142452
  • Provider Name: DEB ELLIOTT-PEARSON M.D., P.C.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: BANK STREET CLINIC
  • Address: 516 BANK ST
    WALLACE, ID
    ZIP 83873
  • Phone: (208) 752-3016

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NPI Details

DEB ELLIOTT-PEARSON M.D., P.C. is a family medicine in Wallace, 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. DEB ELLIOTT-PEARSON M.D., P.C. NPI is 1619142452. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bank Street Clinic.

The provider's business location address is:

516 BANK ST
WALLACE, ID
ZIP 83873-225
Phone: (208) 752-3016
Fax: (208) 753-1001

The provider's authorized official is Deborah Lois Elliott-pearson .
The authorized official title is Ceo and has the following contact phone number (208) 752-3016.

The enumeration date for this NPI number is 4/23/2008 and was last updated on 4/29/2008.

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
1207Q00000XFamily MedicineM7469IDAHOYes

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
1G39437MEDICARE UPINIDAHO
2805230000MEDICAIDIDAHO
31374405MEDICARE PINIDAHO
41881616639MEDICARE PIN

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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