Organization
CAPITAL CITY FAMILY MEDICINE PA
Active
Other names
CAPITAL CITY FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIZ A FRISBEY (OFFICE MANAGER)
(208) 947-7700
Entity
Organization
Contact information
Practice address
1520 W STATE ST, STE 100, BOISE, ID 83702-4084
(208) 947-7700
(208) 947-7711
Mailing address
1520 W STATE ST, STE 100, BOISE, ID 83702-4084
(208) 947-7700
(208) 947-7711
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8052516
MEDICAID MID-LEVEL GROUP
ID
05
—
8052796
—
ID
Enumeration date
06/25/2006
Last updated
06/17/2008
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