Pioneer Family Medicine Pllc

LBN: Pioneer Family Medicine Pllc
Pioneer Family Medicine Pllc is an health care organization with primary practice located at 4740 N. Penngrove Way Ste. 100, Meridian ID 83646. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Pioneer Family Medicine Pllc can be contacted via phone (208) 938-3663, or through Ludwig, Jason Scott via phone (208) 938-3663.

Contact Information

Primary practice address
4740 N. Penngrove Way Ste. 100 Meridian ID 83646
Phone: (208) 938-3663
Fax: (208) 938-3664
Website:
Map and Directions
Authorized official contact:
Name: Ludwig, Jason Scott Doctor of Osteopathy (DO)
Phone: (208) 938-3663

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X O-253 Idaho

Profile Details

NPI number 1952335929
LBN Legal business name Pioneer Family Medicine Pllc
DBA Doing business as
Authorized official Ludwig, Jason Scott Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 10th, 2006
Last updated Aug 23rd, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952335929 NPPES
Idaho MEDICAID 806456700

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