Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eagle Family Medicine P A

Organization Family Medicine Physician · NPI 1417054693

Eagle Family Medicine P A is a Family Medicine Physician in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006

Practice location Address checks out

100 Cottonwood Ct Ste 100
Eagle, ID 83616-6576
Phone: (208) 939-3197
Fax: (208) 939-3263
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence M-7050 (ID)

Record details

NPI number1417054693
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shawn Nowierski — Owner · (208) 939-3197
NPI enumeratedSeptember 20, 2006
Last updated in NPPESJanuary 5, 2015
Mailing address100 Cottonwood Ct, Suite 100, Eagle, ID 83616-6576

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