# IRONWOOD FAMILY PRACTICE, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083650931
- **Authorized official:** NINA RUTH EVERSON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (208) 667-4557

## Contact information

- **Practice address:** 3815 N SCHREIBER WAY UNIT 102, COEUR D ALENE, ID 83815-8434
- **Practice address phone:** (208) 667-4557
- **Practice address fax:** (208) 765-2887
- **Mailing address:** 3815 N SCHREIBER WAY UNIT 102, COEUR D ALENE, ID 83815-8434
- **Mailing address phone:** (208) 667-4557
- **Mailing address fax:** (208) 765-2887

## Taxonomy

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

## Other

- **Enumeration date:** 06/21/2006
- **Last updated:** 01/10/2025