# TREASURE VALLEY FAMILY MEDICINE, PLLC

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

## Provider details

- **NPI number:** 1841603768
- **Authorized official:** DR. BRIAN KEITH CROWNOVER MD (OWNER/PRESIDENT/PHYSICIAN)
- **Authorized official phone:** (208) 895-0050

## Contact information

- **Practice address:** 2428 N STOKESBERRY PL, MERIDIAN, ID 83646-5035
- **Practice address phone:** (208) 895-0050
- **Practice address fax:** (855) 543-3086
- **Mailing address:** 2428 N STOKESBERRY PL, MERIDIAN, ID 83646-5035
- **Mailing address phone:** (208) 895-0050
- **Mailing address fax:** (208) 887-0033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261QP2300X | Primary Care Clinic/Center | M11819 | ID | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 06/09/2014
- **Last updated:** 09/12/2023