| Brent Blue Md | |
|
190 Mustang Drive Driggs ID 83422-0000 | |
| (307) 733-7835 | |
| (307) 733-6912 |
| Full Name | Brent Blue Md |
|---|---|
| Speciality | Family Medicine |
| Location | 190 Mustang Drive, Driggs, Idaho |
| Authorized Official Name and Position | Brent Blue (OWNER) |
| Authorized Official Contact | 3077337835 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Blue Md Po Box 25 Wilson WY 83014-0025 Ph: (307) 733-7835 | Brent Blue Md 190 Mustang Drive Driggs ID 83422-0000 Ph: (307) 733-7835 |
| NPI Number | 1356556518 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 12/23/2025 |
| Medicare PECOS PAC ID | 2466434113 |
|---|---|
| Medicare Enrollment ID | O20040604000956 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356556518 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Brent A Blue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063467538 PECOS PAC ID: 2466403886 Enrollment ID: I20100920000271 |
Four Peaks Clinic Urgent Care, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 Valley Center Dr, Driggs, ID 83422 Phone: 208-354-4757 Fax: 208-354-4758 | |
Fpc Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 852 Valley Centre Dr, Driggs, ID 83422 Phone: 208-354-4757 Fax: 208-354-4758 | |
Teton County Hospital District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 852 Valley Centre Dr, Driggs, ID 83422 Phone: 208-354-4757 Fax: 307-354-4758 |