Packham, Matthew H
Packham, Matthew H is an individual health care provider with primary practice located at 801 Pole Line Rd W Suite 3880, Twin Falls ID 83301-5810. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Packham, Matthew H can be contacted via phone (208) 814-8500.Contact Information
Primary practice address
801 Pole Line Rd W Suite 3880
Twin Falls ID 83301-5810
Phone: (208) 814-8500
Fax: (208) 734-4143
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | M10701 | Idaho |
Profile Details
| NPI number | 1578502589 |
|---|---|
| LBN Legal business name | Packham, Matthew H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Jan 7th, 2015 - about 9 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 | 1578502589 | NPPES |
| Idaho | MEDICAID | 808416400 |
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