Physician Center a Professional Company Mid Level
NPI #1245414028 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1245414028
- Entity Type
- Organization
- Organization Name
- Physician Center a Professional Company Mid Level
- Primary Specialty
- Family Medicine
- Enumeration Date
- Dec 28, 2007
- Last Updated
- Mar 9, 2013
Practice Location
- Address
- 775 POLE LINE RD W
- Address 2
- SUITE 105 & 111
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-5814
- Phone
- (208) 814-8000
Authorized Official
- Name
- MITCHELL J MOFFITT, MD
- Title
- PHYSICIAN
- Phone
- (208) 814-8000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
| Family Medicine |
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