Preucil, Jennifer L

Preucil, Jennifer L is an individual health care provider with primary practice located at 2550 Addison Ave E Suite B, Twin Falls ID 83301-6749. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Preucil, Jennifer L can be contacted via phone (208) 814-7700.

Contact Information

Primary practice address
2550 Addison Ave E Suite B Twin Falls ID 83301-6749
Phone: (208) 814-7700
Fax: (208) 933-9301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M7812 Idaho

Profile Details

NPI number 1922042209
LBN Legal business name Preucil, Jennifer L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Dec 29th, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922042209 NPPES
Idaho MEDICAID 805473400
Idaho Other P00460913

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