Individual
MADISON BEATTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4300 E FLAMINGO AVE, NAMPA, ID 83687-3138
(208) 463-5000
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-15251
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2017
Last updated
05/03/2024
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