Organization
BMH, INC.
Active
Other names
BINGHAM MEMORIAL SPECIALTY CLINIC - POPLAR
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB ERICKSON (CEO)
(208) 785-4100
Entity
Organization
Contact information
Practice address
235 POPLAR ST, BLACKFOOT, ID 83221
(208) 785-3828
(208) 785-9428
Mailing address
98 POPLAR ST, BLACKFOOT, ID 83221-1758
(208) 785-4100
(208) 782-2984
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
—
ID
207RN0300X
Nephrology Physician
Primary
—
ID
2085R0204X
Vascular & Interventional Radiology Physician
—
ID
Other
Enumeration date
03/03/2017
Last updated
12/16/2019
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