Fernandez, Luis

Fernandez, Luis is an individual health care provider with primary practice located at 2850 Olympus Dr. , 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. Fernandez, Luis can be contacted via phone (208) 239-3815.

Contact Information

Primary practice address
2850 Olympus Dr. Pocatello ID 83201
Phone: (208) 239-3815
Fax: (208) 239-3814
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M8581 Idaho

Profile Details

NPI number 1841299302
LBN Legal business name Fernandez, Luis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Dec 28th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841299302 NPPES
Idaho MEDICAID 805465900
Idaho Other J7871
Idaho Other J7855
Idaho Other J7863
Idaho Other 52282
Idaho Other B5763
Idaho Other J7889

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