NPI 1154561116

Joseph W Ippolito Jr MD PLLC

Organisation Preferred Provider Organization Twin Falls, ID

Practice location

Address: 526 Shoup Ave W Suite F, Twin Falls, ID 83301-4591
Phone: (208) 736-7620
Fax: (208) 735-9537

Authorised official

Name: Joseph W Ippolito
Title: Medical Doctor/Owner
Phone: (208) 736-7620

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence M7008 (ID)

Other Preferred Provider Organization providers in Idaho →

Registry record

NPI: 1154561116
Entity type: Organization
NPI issued: 3 Mar 2009
Record last updated: 29 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.