Organization
TAMARACK EAGLE MEDICAL
Active
Other names
Tamarack Medical & Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROURKE YEAKLEY M.D. (SOLE MEMBER)
(208) 724-7420
Entity
Organization
Contact information
Practice address
311 VILLAGE DR, TAMARACK, ID 83615-5014
(208) 724-7420
Mailing address
5701 WILLOW CREEK RD, EAGLE, ID 83616-2025
(208) 724-7420
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
208D00000X
General Practice Physician
Primary
M8190
ID
Other
Enumeration date
04/15/2011
Last updated
04/15/2011
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