Healthcare Provider Details

I. General information

NPI: 1124965553
Provider Name (Legal Business Name): HPC MEDICAL GROUP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N CURTIS RD STE 302
BOISE ID
83706-1347
US

IV. Provider business mailing address

784 S CLEARWATER LOOP STE B
POST FALLS ID
83854-9599
US

V. Phone/Fax

Practice location:
  • Phone: 918-284-9579
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DEREK DANIEL HAYTON
Title or Position: MANAGING MEMBER
Credential: DO
Phone: 918-284-9579