| Tripp Family Medicine, Inc. | |
|
1411 Fillmore St Suite 600 Twin Falls ID 83301-3343 | |
| (208) 933-4400 | |
| (208) 933-4401 |
| Full Name | Tripp Family Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1411 Fillmore St, Twin Falls, Idaho |
| Authorized Official Name and Position | Jonathan Paul Tripp (PRESIDENT) |
| Authorized Official Contact | 2089334400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tripp Family Medicine, Inc. 1411 Fillmore St Suite 600 Twin Falls ID 83301-3343 Ph: (208) 933-4400 | Tripp Family Medicine, Inc. 1411 Fillmore St Suite 600 Twin Falls ID 83301-3343 Ph: (208) 933-4400 |
| NPI Number | 1043578883 |
|---|---|
| Provider Enumeration Date | 04/30/2012 |
| Last Update Date | 04/30/2012 |
| Medicare PECOS PAC ID | 2668635723 |
|---|---|
| Medicare Enrollment ID | O20120530000093 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043578883 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O-0539 (Idaho) | Primary |
| Provider Name | Jonathan P Tripp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558491936 PECOS PAC ID: 7416997432 Enrollment ID: I20120530000114 |
| Provider Name | Blake Taylor Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649739392 PECOS PAC ID: 7214333533 Enrollment ID: I20210910001680 |
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