National Provider Identifier Database

IDAHO PHYSICIANS CLINIC
Rural Health


Contact Information

IDAHO PHYSICIANS CLINIC
98 POPLAR ST
BLACKFOOT, ID83221-1758
Phone: 208-785-3800
Fax:
Website:
Specialty Taxonomy Code
* Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for IDAHO PHYSICIANS CLINIC

NPI Number 1114907532
Legal business name
LBN
IDAHO PHYSICIANS CLINIC
Authorized official LOUIS KRAML - (CEO)
Entity Organization
Organization subpart No
Enumeration date 01/20/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • ID License #: 36
  • ID Other: 8F496 BLUE CROSS PROVIDER #
  • ID Other: 000010137702 BLUE SHIELD PROVIDER #

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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