Clifford, Kyle L
Clifford, Kyle L is an individual health care provider with primary practice located at 2006 Birdie Thompson Drive , Pocatello ID 83201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Clifford, Kyle L can be contacted via phone (208) 232-1132.Contact Information
Primary practice address
2006 Birdie Thompson Drive
Pocatello ID 83201
Phone: (208) 232-1132
Fax: (208) 232-1134
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M9775 | Idaho |
Profile Details
| NPI number | 1841285590 |
|---|---|
| LBN Legal business name | Clifford, Kyle L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 19th, 2005 |
| Last updated | Aug 5th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841285590 | NPPES |
| Idaho | MEDICAID | 807255600 |
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