Idaho Minor Emergency and Family Practice PA

NPI #1205996063 in Meridian, Idaho

Provider Information

NPI Number: 1205996063
Entity Type: Organization
Organization Name: Idaho Minor Emergency and Family Practice PA
Primary Specialty: Clinic/Center
Enumeration Date: Dec 11, 2006
Last Updated: Mar 27, 2013

Practice Location

Address: 3041 EAST COPPER POINTE DRIVE
City: Meridian
State: Idaho
ZIP Code: 83642
Phone: (208) 514-4400

Authorized Official

Name: MR. RAYMOND PAUL HOOFT, M.D.
Title: OWNER, CEO
Phone: (208) 514-4400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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