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Organization

PIONEER FAMILY MEDICINE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JASON SCOTT LUDWIG DO (OWNER)
(208) 938-3663
Entity
Organization

Contact information

Practice address
4740 N. PENNGROVE WAY, STE. 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664
Mailing address
4740 N. PENNGROVE WAY, STE. 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
O-253
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
806456700
ID
Enumeration date
07/10/2006
Last updated
08/23/2019
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