Organization
FAMILY MEDICAL CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LAWRENCE TORQUATO M.D. (PRESIDENT)
(208) 772-7850
Entity
Organization
Contact information
Practice address
265 W PRAIRIE SHOPPING CTR, HAYDEN, ID 83835-9855
(208) 772-7850
(208) 772-2313
Mailing address
265 W PRAIRIE SHOPPING CTR, HAYDEN, ID 83835-9855
(208) 772-7850
(208) 772-2313
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-7938
ID
363AM0700X
Medical Physician Assistant
PAG-019
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8058948
—
ID
Enumeration date
12/29/2010
Last updated
12/29/2010
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