Organization
IDAHO MINOR EMERGENCY AND FAMILY PRACTICE PA
Active
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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