# CLIFFORD FAMILY MEDICINE

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

## Provider details

- **NPI number:** 1396276945
- **Authorized official:** DR. KYLE LAYTON CLIFFORD M.D. (OWNER)
- **Authorized official phone:** (208) 241-5093

## Contact information

- **Practice address:** 4750 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2336
- **Practice address phone:** (208) 251-0316
- **Mailing address:** 1456 ARAMIS, POCATELLO, ID 83204-5046
- **Mailing address phone:** (208) 232-0698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M-9775 | ID | Yes |

## Other

- **Enumeration date:** 03/24/2017
- **Last updated:** 03/24/2017