Organization
FAMILY PRACTICE ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD M LEVIN D.O. (PHYSICIAN)
(208) 788-3200
Entity
Organization
Contact information
Practice address
21 E MAPLE ST, SUITE A, HAILEY, ID 83333-8401
(208) 788-3200
(208) 788-3386
Mailing address
21 E MAPLE ST, SUITE A, HAILEY, ID 83333-8401
(208) 788-3200
(208) 788-3386
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O14
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807644700
—
ID
01
—
DG4201
RR MEDICARE
ID
Enumeration date
07/08/2006
Last updated
03/09/2013
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