Individual
VICKY M LOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
623 SOUTH MAIN STREET, MOSCOW, ID 83843
(208) 882-2011
(208) 883-1853
Mailing address
623 SOUTH MAIN STREET, MOSCOW, ID 83843
(208) 882-2011
(208) 883-1853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M8278
ID
207Q00000X
Family Medicine Physician
MD00040077
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138246
REGENCE BLUESHIELD
ID
01
—
0159575
WA LABOR & INDUSTRIES
WA
05
—
1004375
—
WA
01
—
1104639
DMERC
ID
01
—
48264
BLUE CROSS
ID
01
—
806323500
HEATHY CONNECTIONS
ID
05
—
806323500
—
ID
05
—
8298937
—
WA
Enumeration date
10/23/2006
Last updated
07/14/2025
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