Organization
MARION LUQUE,PLLC
Active
Other names
Winding Creek Medical Arts
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARION LYNN LUQUE M.D. (OWNER)
(208) 938-8887
Entity
Organization
Contact information
Practice address
1139 E. WINDING CREEK DR, EAGLE, ID 83616
(208) 938-8887
(208) 938-8897
Mailing address
502 E. TWO RIVERS DR, EAGLE, ID 83616
(208) 559-3303
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M8345
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805377200
—
ID
01
—
M8345
STATE LICENSE
ID
Enumeration date
09/19/2006
Last updated
04/07/2014
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