Family Practice Residency of Idaho, Inc
Organization Active NPI Family Medicine Physician · Boise, ID
NPI 1982632550 · NPPES record last updated Jan 30, 2008
Key facts
- NPI
- 1982632550
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FAMILY PRACTICE RESIDENCY OF IDAHO, INC
- Practice address
- 777 N Raymond St
Boise, ID 83704-9251 - Phone
- (208) 367-6030
- Fax
- (208) 367-6123
- NPI assigned
- Jun 30, 2006
- Organization subpart
- No
Authorized official
- Name
- Ted Epperly, M.D.
- Title
- Chairman and Program Director
- Phone
- (208) 367-6042
Member of 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
777 N Raymond St
Boise, ID 83704-9251
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 367-6030
Other names
- Family Practice Medical Center
Other providers in Boise, ID
- Family Care Clinic LLC
- Family Care Clinic, LLC
- Family Connection, Inc.
- Family First Home Care LLC
- Family Practice Medical
- Alexi Dimitrios Fanopoulos
- Amy Faragher
- Kaylin Faranda
- Susan L Farber
- Mallory Hope Faricy
All providers in Boise, 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 Jan 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.