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Lee Self Md Pa
Primary Care Clinic/Center in Emmett, Idaho
NPI 1346400744

Lee Self Md Pa is a Primary Care Clinic/Center based in Ola, ID and is specialized in Primary Care. Lee Self Md Pa practices in Emmett, ID. The NPI Number for Lee Self Md Pa is 1346400744 and holds a License No. M7844 (Idaho).

The current practice location address for Lee Self Md Pa is 2020 S Johns Ave Ste B, Emmett, ID and can be reached out via phone at 208-425-7507 and via fax at 208-584-9341. You can also correspond with Lee Self Md Pa through the mailing address at 23000 SWEET OLA HWY, OLA, ID - 83657-5027 (mailing address contact number: 208-425-7507).

Location: 2020 S Johns Ave Ste B, Emmett, ID, 83657-5027
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1346400744
Provider Name
Lee Self Md Pa
Credential
Provider Entity Type
Organization
Address
2020 S Johns Ave Ste B, Emmett, ID, 83657-5027
Phone Number
208-425-7507
Fax Number
208-584-9341
Provider Enumeration Date
06/10/2008
Last Update Date
03/12/2024
institution
Provider Business Practice Location Address Details
Address
2020 S Johns Ave Ste B
City
Emmett
State
Idaho
Zip
83617-9410
Phone Number
208-425-7507
Fax Number
208-584-9341
person
Provider Business Mailing Address Details
Address
2020 S Johns Ave Ste B
City
Emmett
State
Idaho
Zip
83617-9410
Phone Number
208-425-7507
Fax Number
208-584-9341
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
M7844 (Idaho)
Definition
Definition to come...
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