Clifford Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

M-9775 Issued in ID

Legal business name

CLIFFORD FAMILY MEDICINE

Practice address

4750 Yellowstone Ave
Chubbuck, ID 83202-2336

Phone

(208) 251-0316

NPI assigned

Mar 24, 2017

Last updated

Mar 24, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kyle Layton Clifford, M.D.NPI 1841285590

Title

Owner

Phone

(208) 241-5093

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kyle L Clifford, MD

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1841285590
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490313600000",
    "number": "1396276945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 ARAMIS",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832045046",
            "telephone_number": "208-232-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022336",
            "telephone_number": "208-251-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLIFFORD FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-24",
        "last_updated": "2017-03-24",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "LAYTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-241-5093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-9775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chubbuck Chiropractic PA
• Chubbuck Fire Department
• Chubbuck Kidz Dental PC
• Jan Fisher Clark, LPC
• Aaron Clayson, AG-NP
• Elisabeth Clonts
• Jeanna Chay Colborn, MA, SE
• Lavon Marie Cole, LCPC
• Tanja Dawn Cornelison, LCPC
• David Covey Jr., LMFT

• Family Medicine Physician in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.