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

Specialized Family Medicine

Organization Family Medicine Physician · NPI 1124197702

Specialized Family Medicine is a Family Medicine Physician in Pocatello, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
In the registry since
2006

Practice location Address checks out

151 N 4th Ave Ste B
Pocatello, ID 83201-6300
Phone: (208) 369-7147
Fax: (208) 416-6522
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X (ID)

Record details

NPI number1124197702
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jordan Bailey — Physician Owner · (208) 269-7147
NPI enumeratedNovember 7, 2006
Last updated in NPPESJuly 21, 2022
Mailing address151 N 4th Ave, Suite B, Pocatello, ID 83201-6300

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