Organization
WEST VALLEY MEDICAL GROUP LLC
Active
Organization
WEST VALLEY MEDICAL GROUP LLC
Active
Other names
West Valley Medical Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS JOSEPH (VP)
(615) 373-7630
Entity
Organization
Contact information
Practice address
1906 FAIRVIEW AVE STE 230, CALDWELL, ID 83605-5432
(208) 459-4667
(208) 442-6520
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 373-7600
(866) 346-1426
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807655500
—
ID
05
—
807981600
—
ID
Enumeration date
10/16/2006
Last updated
01/02/2023
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