| Owyhee Family Medicine Pllc | |
|
9858 W State St Star ID 83669-5210 | |
| (208) 286-9471 | |
| Not Available |
| Full Name | Owyhee Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 9858 W State St, Star, Idaho |
| Authorized Official Name and Position | Rory Hawker (OWNER) |
| Authorized Official Contact | 2084227887 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Owyhee Family Medicine Pllc 9858 W State St Star ID 83669-5210 Ph: (208) 286-9471 | Owyhee Family Medicine Pllc 9858 W State St Star ID 83669-5210 Ph: (208) 286-9471 |
| NPI Number | 1245910470 |
|---|---|
| Provider Enumeration Date | 07/21/2023 |
| Last Update Date | 07/21/2023 |
| Medicare PECOS PAC ID | 2769825900 |
|---|---|
| Medicare Enrollment ID | O20240205003399 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245910470 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rory Hawker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710509443 PECOS PAC ID: 8820411341 Enrollment ID: I20230914001281 |
| Provider Name | Carlee C Huesman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790466803 PECOS PAC ID: 0749727626 Enrollment ID: I20240809000649 |
| Provider Name | Elena Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316617681 PECOS PAC ID: 1557870433 Enrollment ID: I20250602003457 |
Accident Recovery Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12056 W Foxhaven St, Star, ID 83669 Phone: 801-318-8869 |