Organization
MACHEN FAMILY MEDICINE, PC
Active
Parent organization
MACHEN FAMILY MEDICINE, PC
Other names
SHANE G MACHEN, DO
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACHEN FAMILY MEDICINE, PC
Authorized official
SHANE G MACHEN DO (OWNER)
(208) 522-7666
Entity
Organization
Contact information
Practice address
1995 E 17TH ST STE A, IDAHO FALLS, ID 83404-6493
(208) 522-7666
(208) 524-2821
Mailing address
1995 E 17TH ST STE A, IDAHO FALLS, ID 83404-6493
(208) 522-7666
(208) 524-2821
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-0611
ID
Other
Enumeration date
07/06/2011
Last updated
04/26/2012
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