Kack, Rod D
Kack, Rod D is an individual health care provider with primary practice located at 706 N College Rd Ste C , Twin Falls ID 83301-5824. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kack, Rod D can be contacted via phone (208) 735-1000.Contact Information
Primary practice address
706 N College Rd Ste C
Twin Falls ID 83301-5824
Phone: (208) 735-1000
Fax: (208) 732-5345
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | M6895 | Idaho |
Profile Details
| NPI number | 1629123815 |
|---|---|
| LBN Legal business name | Kack, Rod D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2007 |
| Last updated | Feb 6th, 2012 - about 13 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 | 1629123815 | NPPES |
| Idaho | MEDICAID | 805168100 |
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