Organization
GEM FAMILY MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACEY VERNALEE MARSON (OFFICE MANAGER)
(208) 365-3455
Entity
Organization
Contact information
Practice address
1108 SOUTH WASHINGTON AVE, EMMETT, ID 83617-3535
(208) 365-3455
(208) 365-3422
Mailing address
1108 SOUTH WASHINGTON AVE, EMMETT, ID 83617-3535
(208) 365-3455
(208) 365-3422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
N-33941
ID
207Q00000X
Family Medicine Physician
Primary
NP-701A
ID
Other
Enumeration date
10/07/2011
Last updated
10/07/2011
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