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Organization

FAMILY PRACTICE RESIDENCY OF IDAHO, INC

Active
Other names
Family Practice Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
TED EPPERLY M.D. (CHAIRMAN AND PROGRAM DIRECTOR)
(208) 367-6042
Entity
Organization

Contact information

Practice address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
(208) 367-6123
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 367-6030
(208) 367-6123

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
06/30/2006
Last updated
01/30/2008
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