Family Medicine & Medicine

NPI #1194136515 in Ketchum, Idaho

Provider Information

NPI Number: 1194136515
Entity Type: Organization
Organization Name: Family Medicine & Medicine
Primary Specialty: Physician Assistant
Enumeration Date: May 20, 2014
Last Updated: May 20, 2014

Practice Location

Address: 380 WASHINGTON AVE
Address 2: SUITE 204
City: Ketchum
State: Idaho
ZIP Code: 83340-1575
Phone: (208) 725-0900

Authorized Official

Name: MRS. NANETTE FORD, P.A.-C
Title: PRESIDENT
Phone: (208) 725-0900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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