Organization
ADVANCED FAMILY MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W FOUTZ M.D. (MANAGING PARTNER)
(208) 922-3355
Entity
Organization
Contact information
Practice address
943 LINDER RD, #103, KUNA, ID 83634-3395
(208) 922-3355
(208) 922-9499
Mailing address
943 LINDER RD, #103, KUNA, ID 83634-3395
(208) 922-3355
(208) 922-9499
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806958500
—
ID
Enumeration date
01/02/2007
Last updated
09/10/2008
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