Organization Name: | WOOD RIVER FAMILY MEDICINE PLLC |
NPI Number: | 1346441912 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CARL A BARBEE (PHYSICIAN) |
Mailing Address: | 706 S Main St Hailey |
State: | ID US |
Postal Code: | 833338400 |
Phone Number: | 2087883434 |
Fax Number: | 2087882025 |
NPI Enumeration Date: | 05/30/2007 |
NPI Last Update Date: | 07/15/2007 |
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: |