NPI 1003325937

Matthew Frank Ivie, PAC

Practitioner Medical Physician Assistant Gooding, ID

Practice location

Address: 267 N Canyon Dr, Gooding, ID 83330-5500
Phone: (208) 934-4433
Mailing address: 940 E 1400 N, Shelley, ID 83274-5143

Registered specialties

Medical Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363AM0700X

Other Physician Assistant providers in Idaho →

Registry record

NPI: 1003325937
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Sep 2017
Record last updated: 22 Sep 2017

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.