Organization
ST BENEDICTS FMC PHYSICIAN ASSISTANTS
Active
Parent organization
ST BENEDICTS FAMILY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST BENEDICTS FAMILY MEDICAL CENTER
Authorized official
ALAN STEVENSON (ADMINISTRATOR)
(208) 324-1122
Entity
Organization
Contact information
Practice address
709 N LINCOLN AVE, JEROME, ID 83338-1851
(208) 324-4301
(208) 324-9529
Mailing address
709 N LINCOLN AVE, JEROME, ID 83338-1851
(208) 324-4301
(208) 324-9529
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
08
ID
Other
Enumeration date
05/09/2008
Last updated
05/09/2008
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