| Advanced Family Medicine Pllc | |
|
943 Linder Rd #103 Kuna ID 83634-3395 | |
| (208) 922-3355 | |
| (208) 922-9499 |
| Full Name | Advanced Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 943 Linder Rd, Kuna, Idaho |
| Authorized Official Name and Position | Michael W Foutz (MANAGING PARTNER) |
| Authorized Official Contact | 2089223355 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Family Medicine Pllc 943 Linder Rd #103 Kuna ID 83634-3395 Ph: (208) 922-3355 | Advanced Family Medicine Pllc 943 Linder Rd #103 Kuna ID 83634-3395 Ph: (208) 922-3355 |
| NPI Number | 1598822231 |
|---|---|
| Provider Enumeration Date | 01/02/2007 |
| Last Update Date | 09/10/2008 |
| Medicare PECOS PAC ID | 2264494798 |
|---|---|
| Medicare Enrollment ID | O20041027001226 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598822231 | NPI | - | NPPES |
| 806958500 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael W Foutz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992782361 PECOS PAC ID: 5698737120 Enrollment ID: I20041027001271 |
| Provider Name | Susan J Sansom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538611397 PECOS PAC ID: 8123300191 Enrollment ID: I20170126002639 |
| Provider Name | Jennifer D Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538631189 PECOS PAC ID: 7214278704 Enrollment ID: I20190410001420 |
| Provider Name | Anthony Thiros |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114412707 PECOS PAC ID: 9133542657 Enrollment ID: I20230810002347 |
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