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

Southeastern Idaho Medical Clinics

Organization Family Medicine Physician · NPI 1982738662

Southeastern Idaho Medical Clinics is a Family Medicine Physician in Malad City, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
Specialties on file
2

Practice location Address checks out

230 W 200 N
Malad City, ID 83252-1109
Phone: (208) 766-2267
Fax: (208) 766-2342
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0-41 (ID)
Rural Health Clinic/Center Taxonomy 261QR1300X · Licence 0-41 (ID)

Record details

NPI number1982738662
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Johnson — Medical Director · (208) 766-2267
Other names Malad Valley Clinic
NPI enumeratedMarch 15, 2007
Last updated in NPPESSeptember 11, 2025
Mailing address2750 S 4100 W, Malad City, ID 83252-6542

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