NPI 1255621835

Tamarack Eagle Medical

Organisation General Practice Physician Tamarack, ID

Practice location

Address: 311 Village Dr, Tamarack, ID 83615-5014
Phone: (208) 724-7420
Mailing address: 5701 Willow Creek Rd, Eagle, ID 83616-2025

Authorised official

Name: Rourke Yeakley
Title: Sole Member
Phone: (208) 724-7420

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence M8190 (ID)

Other General Practice providers in Idaho →

Dentist

Dental Providers Taxonomy 122300000X

Other Dentist providers in Idaho →

Registry record

NPI: 1255621835
Entity type: Organization
NPI issued: 15 Apr 2011
Record last updated: 15 Apr 2011

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.