PAYETTE LAKES MEDICAL CLINIC, PA; NPI #1255462263

Contact Information

PAYETTE LAKES MEDICAL CLINIC, PA

211 FOREST STREET
MCCALL, ID 83638

Phone: 208-634-2225
Fax: 208-634-7212
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Primary Care	261QP2300X

Indicates primary specialty

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NPI Profile & details for PAYETTE LAKES MEDICAL CLINIC, PA

NPI # 1255462263

LBN Legal business name PAYETTE LAKES MEDICAL CLINIC, PA

Authorized official JACQUELINE BRUNS - (VP - PHYSICIAN SERVICES)

Entity Organization

Organization subpart ¹ No

Enumeration date 03/08/2007

Last updated 03/11/2008 - About 18 years ago

Identifiers

ID	Other	8934-2	BLUE CROSS
ID	Other	000010006343	BLUE SHIELD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PAYETTE LAKES MEDICAL CLINIC, PA

Contact Information

Specialty

Primary Care

NPI Profile & details for PAYETTE LAKES MEDICAL CLINIC, PA

Reviews for PAYETTE LAKES MEDICAL CLINIC, PA