Idaho Modern Medicine - Pllc

LBN: Idaho Modern Medicine - Pllc
Idaho Modern Medicine - Pllc is an health care organization with primary practice located at 1000 Pocatello Creek Rd Ste E10 , Pocatello ID 83201-2953. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Idaho Modern Medicine - Pllc can be contacted via phone (208) 317-5371, or through Anderson, Michael A via phone (208) 648-4789.

Contact Information

Primary practice address
1000 Pocatello Creek Rd Ste E10 Pocatello ID 83201-2953
Phone: (208) 317-5371
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Anderson, Michael A Doctor of Osteopathy (DO)
Phone: (208) 648-4789

Health care specialties

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

Profile Details

NPI number 1184255754
LBN Legal business name Idaho Modern Medicine - Pllc
DBA Doing business as
Authorized official Anderson, Michael A Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Jan 31st, 2020
Last updated Feb 5th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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