Praxis Medical Group

NPI 1255676789 - Internal Medicine - 207R00000X

NPI Details
NPI 1255676789
Enumeration Date 12/10/2012
Last Updated 12/10/2012
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name GARRETT TK GARRETT
Position BOARD DIRECTOR
Phone (208) 884-3770
Fax (541) 278-8360
Practice Location
3080 E GENTRY WAY
SUITE 200
MERIDIAN ID, 83642-3544, US
Phone (208) 884-3770
Fax (541) 278-8360
Business Location
PO BOX 670
BEND OR, 97709-0670, US
Phone (541) 884-3770
Fax (541) 278-8360
Toxanomy
Taxonomy Code 207R00000X
License State Idaho
License Number M-7522
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According to our database, Praxis Medical Group NPI is 1255676789, taxonomy code is 207R00000X and license number is M-7522, license state is located at Idaho. Praxis Medical Group physically located at 3080 E Gentry Way, Meridian ID, 83642-3544. NPI Number 1033115704 has the healthcare provider type.

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1255676789 NPI number is provided on an as is basis without warranty of any kind. 1255676789 is maintained by the National Plan & Provider Enumeration System. The contents of Praxis Medical Group are for informational purposes only.