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General NPI Number Information
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NPI Number | 1093513731
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Entity Type | Organization
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Legal Business Name | WENDELL FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 410 N IDAHO ST
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City | WENDELL
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State | ID
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Zip | 83355-5038
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Country | US
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Telephone | 208-990-3226
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Fax | 888-440-7959
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Provider Business Mailing Address
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Address Line | PO BOX 505
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City | WENDELL
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State | ID
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Zip | 83355-0505
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. BRITTNI MCLAM
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Credential | DO
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Telephone | 208-990-3241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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