# UPPER VALLEY FAMILY MEDICINE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UPPER VALLEY FAMILY MEDICINE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073697884
- **Authorized official:** DARIN T BERRETT (OFFICE MANAGER)
- **Authorized official phone:** (208) 745-5021

## Contact information

- **Practice address:** 711 RIGBY LAKE DR STE 115, RIGBY, ID 83442-5230
- **Practice address phone:** (208) 745-5021
- **Practice address fax:** (208) 745-5026
- **Mailing address:** 711 RIGBY LAKE DR STE 115, RIGBY, ID 83442-5230
- **Mailing address phone:** (208) 745-5021
- **Mailing address fax:** (208) 745-5026

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2006
- **Last updated:** 07/21/2022