Blackfoot Medical Clinic Rhc

NPI #1124283254 in Blackfoot, Idaho

Provider Information

NPI Number: 1124283254
Entity Type: Organization
Organization Name: Blackfoot Medical Clinic Rhc
Primary Specialty: Family Medicine
Enumeration Date: Jul 29, 2008
Last Updated: Jul 31, 2008

Practice Location

Address: 1441 PARKWAY DR
City: Blackfoot
State: Idaho
ZIP Code: 83221-1667
Phone: (208) 785-2600

Authorized Official

Name: SHEILA TIBBITTS
Title: ADMINISTRATOR
Phone: (208) 785-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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