Specialized Family Medicine

LBN: Specialized Family Medicine
Specialized Family Medicine is an health care organization with primary practice located at 151 N 4Th Ave Suite B, Pocatello ID 83201-6300. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Specialized Family Medicine can be contacted via phone (208) 369-7147, or through Bailey, Jordan L via phone (208) 269-7147.

Contact Information

Primary practice address
151 N 4Th Ave Suite B Pocatello ID 83201-6300
Phone: (208) 369-7147
Fax: (208) 416-6522
Website:
Map and Directions
Authorized official contact:
Name: Bailey, Jordan L Doctor of Medicine (MD)
Phone: (208) 269-7147

Health care specialties

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

Profile Details

NPI number 1124197702
LBN Legal business name Specialized Family Medicine
DBA Doing business as
Authorized official Bailey, Jordan L Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2006
Last updated Jul 21st, 2022 - about 2 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 1124197702 NPPES
Idaho Other 8F991 BLUE CROSS
Idaho MEDICAID 806364600 BLUE CROSS

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