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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