Organization
CLIFFORD FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE LAYTON CLIFFORD M.D. (OWNER)
(208) 241-5093
Entity
Organization
Contact information
Practice address
4750 YELLOWSTONE AVE, CHUBBUCK, ID 83202-2336
(208) 251-0316
Mailing address
1456 ARAMIS, POCATELLO, ID 83204-5046
(208) 232-0698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-9775
ID
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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