State of Idaho
State of Idaho is a Family Medicine Physician in Nampa, Idaho. Registered with an NPI since 2007.
- In the registry since
- 2007
Practice location Address checks out
1660 11th Ave NNampa, ID 83687-5000
Phone: (208) 442-2812
Fax: (208) 467-5978
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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 |
|---|
Record details
| NPI number | 1265558019 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Sue Broetje — Administrative Director · (208) 442-2812 |
| Other names | Dhw Issh Group Physicians |
| NPI enumerated | March 22, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 1660 11th Ave N, Nampa, ID 83687-5000 |
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