# GARDNER & GARDNER, PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cama Prairie Family Physicians
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477551794
- **Authorized official:** DR. JIM GARDNER MO (PRESIDENT)
- **Authorized official phone:** (208) 983-3000

## Contact information

- **Practice address:** 203 N A ST, GRANGEVILLE, ID 83530-1201
- **Practice address phone:** (208) 983-3000
- **Practice address fax:** (208) 983-9276
- **Mailing address:** 203 N A ST, GRANGEVILLE, ID 83530-1201
- **Mailing address phone:** (208) 983-3000
- **Mailing address fax:** (208) 983-9276

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M6670 | ID | Yes |
| 207Q00000X | Family Medicine Physician | M6671 | ID | — |
| 207Q00000X | Family Medicine Physician | NP416A | ID | — |

## Other

- **Enumeration date:** 07/11/2005
- **Last updated:** 08/22/2020