| Southern Idaho Medicine Pllc | |
|
207 E Main St Jerome ID 83338-2334 | |
| (208) 308-7738 | |
| Not Available |
| Full Name | Southern Idaho Medicine Pllc |
|---|---|
| Speciality | Clinic/center |
| Location | 207 E Main St, Jerome, Idaho |
| Authorized Official Name and Position | Jessicca Marie Crismor (OWNER) |
| Authorized Official Contact | 2083087738 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Idaho Medicine Pllc 137 Woodridge Dr Twin Falls ID 83301-8156 Ph: (208) 308-7738 | Southern Idaho Medicine Pllc 207 E Main St Jerome ID 83338-2334 Ph: (208) 308-7738 |
| NPI Number | 1861105694 |
|---|---|
| Provider Enumeration Date | 12/26/2022 |
| Last Update Date | 12/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861105694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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