# PHYSICIANS CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MCMILLAN MEDICAL CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073601233
- **Authorized official:** MRS. CORINNE K CHASTAIN (OFFICE MANAGER)
- **Authorized official phone:** (208) 375-0500

## Contact information

- **Practice address:** 4750 N FIVE MILE RD, BOISE, ID 83713-2715
- **Practice address phone:** (208) 375-0500
- **Practice address fax:** (208) 375-4310
- **Mailing address:** 4750 N FIVE MILE RD, BOISE, ID 83713-2715
- **Mailing address phone:** (208) 375-0500
- **Mailing address fax:** (208) 375-4310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/11/2006
- **Last updated:** 08/22/2020