Organization Name: | KUNA MINOR EMERGENCY LLC |
NPI Number: | 1144412719 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOUGLAS K MCVEY (OWNER) |
Mailing Address: | 708 E Wythe Creek Ct Kuna |
State: | ID US |
Postal Code: | 836342473 |
Phone Number: | 2089225338 |
Fax Number: | 2089225340 |
NPI Enumeration Date: | 08/16/2007 |
NPI Last Update Date: | 08/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |