| Kurt E Kracaw MD LLC | |
|
426 Farnsworth Way Ste 1 Rigby ID 83442-4713 | |
| (208) 745-9411 | |
| (208) 745-9910 |
| Full Name | Kurt E Kracaw MD LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 426 Farnsworth Way Ste 1, Rigby, Idaho |
| Authorized Official Name and Position | Kurt Edwin Kracaw (OWNER) |
| Authorized Official Contact | 7757724208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kurt E Kracaw MD LLC Po Box 3208 Idaho Falls ID 83403-3208 Ph: (208) 523-4906 | Kurt E Kracaw MD LLC 426 Farnsworth Way Ste 1 Rigby ID 83442-4713 Ph: (208) 745-9411 |
| NPI Number | 1467963496 |
|---|---|
| Provider Enumeration Date | 10/17/2017 |
| Last Update Date | 04/03/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467963496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | M-13115 (Idaho) | Primary |
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