Organization
WEST IDAHO IMEDCARE
Active
Organization
WEST IDAHO IMEDCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANAEL HOGG DO (OWNER)
(808) 294-7862
Entity
Organization
Contact information
Practice address
22872 AURA VISTA WAY, CALDWELL, ID 83607-5593
(808) 294-7862
Mailing address
PO BOX 188, GREENLEAF, ID 83626-0188
(208) 261-2030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/04/2025
Last updated
03/04/2025
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