Organization
TARTER FAMILY MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAN TARTER (OWNER)
(208) 880-8919
Entity
Organization
Contact information
Practice address
1560 N CRESTMONT DR STE A, MERIDIAN, ID 83642-2178
(208) 650-4888
(208) 650-4892
Mailing address
1560 N CRESTMONT DR STE A, MERIDIAN, ID 83642-2178
(208) 650-4888
(208) 650-4892
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP439A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275631244
INDIVIDUAL NPI
ID
Enumeration date
09/15/2015
Last updated
09/18/2018
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