Organization
SHH MEDICAL GROUP LLC
Active
Other names
AUTUMN RIDGE MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
JASON FLETCHER (PRESIDENT)
(208) 376-7298
Entity
Organization
Contact information
Practice address
1221 W IRONWOOD DR STE 102, COEUR D ALENE, ID 83814-1402
(208) 665-8111
(208) 665-8112
Mailing address
PO BOX 1176, MERIDIAN, ID 83680-1176
(208) 376-7298
(208) 377-8310
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
06/26/2019
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