Organization · Type 2 NPI

Madison Co Memorial Hospital

Family Medicine Physician · Rexburg, ID

NPI number 1134592017 Active

Practice location

393 E 2nd N
Rexburg, ID 83440-1605

Fax (208) 356-3111

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	40 (ID)

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

61 other providers at this address

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NPI record

NPI: 1134592017
Entity type: Organization (Type 2)
Issued: Nov 2, 2015
Last updated: Oct 23, 2023
Status: Active
Subpart: Yes of Madison Co Memorial Hospital

Other names

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Madison Memorial Rexburg Medical Clinic · doing business as
Madison Memorial Rexburg Medical Clinic · doing business as

Authorized official

Rachel Gonzales, DM, RN, RODP
Chief Executive Officer
(208) 359-6900

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1134592017

Madison Co Memorial Hospital's National Provider Identifier is 1134592017, issued on Nov 2, 2015. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Rexburg, ID. The record was last updated on Oct 23, 2023.