Organization
UPPER VALLEY FAMILY MEDICINE PLLC
Active
Other names
UPPER VALLEY FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
DARIN T BERRETT (OFFICE MANAGER)
(208) 745-5021
Entity
Organization
Contact information
Practice address
711 RIGBY LAKE DR STE 115, RIGBY, ID 83442-5230
(208) 745-5021
(208) 745-5026
Mailing address
711 RIGBY LAKE DR STE 115, RIGBY, ID 83442-5230
(208) 745-5021
(208) 745-5026
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8067451700
—
ID
05
—
806913600
—
ID
Enumeration date
10/25/2006
Last updated
07/21/2022
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