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General NPI Number Information
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NPI Number | 1548200181
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH CARE OF POST FALLS, PLLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 05/02/2019
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Provider Practice Location Address
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Address Line | 1110 POLSTON AVE STE 1
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 208-773-1311
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Fax | 208-773-1644
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Provider Business Mailing Address
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Address Line | 3773 W 5TH AVE STE 301
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City | POST FALLS
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State | ID
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Zip | 83854-6728
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Country | US
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Telephone | 208-773-1311
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Fax | 208-773-1644
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. MICHAEL L. OGLESBAY
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Credential | D.O.
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Telephone | 208-773-1311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | M8602
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License Number State | ID
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