Physician Center A Professional Company Mid Level
LBN: Physician Center A Professional Company Mid Level
Physician Center A Professional Company Mid Level is an health care organization with primary practice located at 775 Pole Line Rd W Suite 105 & 111, Twin Falls ID 83301-5814. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Physician Center A Professional Company Mid Level can be contacted via phone (208) 814-8000, or through Moffitt, Mitchell J via phone (208) 814-8000.
Contact Information
Primary practice address
775 Pole Line Rd W Suite 105 & 111
Twin Falls ID 83301-5814
Phone: (208) 814-8000
Fax: (208) 733-9402
Website:
Authorized official contact:
Name: Moffitt, Mitchell J Doctor of Medicine (MD)
Phone: (208) 814-8000
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X |
Profile Details
| NPI number | 1245414028 |
|---|---|
| LBN Legal business name | Physician Center A Professional Company Mid Level |
| DBA Doing business as | |
| Authorized official | Moffitt, Mitchell J Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 28th, 2007 |
| Last updated | Mar 9th, 2013 - about 11 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245414028 | NPPES |
| Idaho | MEDICAID | 8050368 |
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