institution
Wallace Bakers Mid-level Group
Medical Physician Assistant in Idaho Falls, Idaho
NPI 1639370810

Wallace Bakers Mid-level Group is a Medical Physician Assistant based in Idaho Falls, ID and is specialized in Medical. Wallace Bakers Mid-level Group practices in Idaho Falls, ID. The NPI Number for Wallace Bakers Mid-level Group is 1639370810 and holds a License No. M6919 (Idaho).

The current practice location address for Wallace Bakers Mid-level Group is 1880 John Adams Pkwy, Idaho Falls, ID and can be reached out via phone at 208-524-6633 and via fax at 208-524-9952. You can also correspond with Wallace Bakers Mid-level Group through the mailing address at 1880 JOHN ADAMS PKWY, IDAHO FALLS, ID - 83401-4315 (mailing address contact number: 208-524-6633).

Location: 1880 John Adams Pkwy, Idaho Falls, ID, 83401-4315
institution
Provider Profile Details
NPI Number
1639370810
Provider Name
Wallace Bakers Mid-level Group
Credential
Provider Entity Type
Organization
Address
1880 John Adams Pkwy, Idaho Falls, ID, 83401-4315
Phone Number
208-524-6633
Fax Number
208-524-9952
Provider Enumeration Date
05/29/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8076593 05 ID
institution
Provider Business Practice Location Address Details
Address
1880 John Adams Pkwy
City
State
Zip
83401-4315
Phone Number
208-524-6633
Fax Number
208-524-9952
person
Provider Business Mailing Address Details
Address
1880 John Adams Pkwy
City
State
Zip
83401-4315
Phone Number
208-524-6633
Fax Number
208-524-9952
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
M6919 (Idaho)
Definition
Definition to come...
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