Individual
DR. MICHAEL M PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
37 S 2ND E, REXBURG, ID 83440-1906
(208) 356-0234
Mailing address
37 S 2ND E, REXBURG, ID 83440-1906
(208) 356-0234
(208) 656-0365
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-7243
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
804159100
—
ID
Enumeration date
10/23/2006
Last updated
09/28/2021
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