Spencer Garrett Seibold, D.O.
Individual provider Active NPI Family Medicine Physician · American Falls, ID
NPI 1114214731 · NPPES record last updated Apr 26, 2019
Key facts
- NPI
- 1114214731
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- O-0803 (ID)
- Practice address
- 502 Tyhee Ave
American Falls, ID 83211-1224 - Phone
- (208) 226-3200
- NPI assigned
- Jul 3, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 20, 2022 through Dec 20, 2026
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- sseibold@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | O-0803 | ID | Yes |
Addresses
Primary practice location
502 Tyhee Ave
American Falls, ID 83211-1224
Mailing address
510 Roosevelt St
American Falls, ID 83211-1362
Other practice location 1
50 S Main
Aberdeen, ID 83210
Phone (208) 226-3200
Other providers in American Falls, ID
- Josiah Brandt Price
- Corey L Richardson
- Ridley'S Family Markets, Inc
- Rockland Pharmacy, Inc
- Rockland Pharmacy, Inc
- Brock Shawver
- Daniel Sterner
- Richard Thomas Sutton
- Bret Andrew Timmons
- Devon Tomkinson
All providers in American Falls, ID · Family Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.