Organization · Type 2 NPI

Family Medicine & Medicine

Physician Assistant · Ketchum, ID

NPI number 1194136515 Active

Practice location

380 Washington Ave, Suite 204
Ketchum, ID 83340-1575

Fax (208) 725-0901

Mailing address

PO Box 1575
Ketchum, ID 83340-1575

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA-126 (ID)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

4 other providers at this address

About NPI 1194136515

Family Medicine & Medicine's National Provider Identifier is 1194136515, issued on May 20, 2014. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Ketchum, ID. The record was last updated on May 20, 2014.