# PREMIER MEDICAL ASSOCIATES LLC

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

## Provider details

- **NPI number:** 1588469621
- **Authorized official:** ISAAC DANIEL MOORE (CEO)
- **Authorized official phone:** (509) 464-9935

## Contact information

- **Practice address:** 2201 N IRONWOOD PL STE 200, COEUR D ALENE, ID 83814-2670
- **Practice address phone:** (208) 274-5839
- **Practice address fax:** (208) 274-9125
- **Mailing address:** 1846 1ST ST STE 100 \#187360, IDAHO FALLS, ID 83401
- **Mailing address phone:** (208) 274-5839

## Taxonomy

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

## Other

- **Enumeration date:** 02/13/2025
- **Last updated:** 02/13/2025