Organization
IDAHO MINOR EMERGENCY AND FAMILY PRACTICE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND PAUL HOOFT M.D. (OWNER, CEO)
(208) 514-4400
Entity
Organization
Contact information
Practice address
3041 EAST COPPER POINTE DRIVE, MERIDIAN, ID 83642
(208) 514-4400
(208) 514-4404
Mailing address
3041 EAST COPPER POINTE DRIVE, MERIDIAN, ID 83642
(208) 514-4400
(208) 514-4404
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13D1049440
CLIA NUMBER
ID
Enumeration date
12/11/2006
Last updated
03/27/2013
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