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General NPI Number Information
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NPI Number | 1548504053
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Entity Type | Organization
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Legal Business Name | URGENT HEALTH CARE P.C.
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Dates
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Enumeration Date | 11/21/2012
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Last Update Date | 11/21/2012
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Provider Practice Location Address
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Address Line | 212 N 3RD ST SUITE B
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City | MCCALL
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State | ID
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Zip | 83638-4414
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Country | US
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Telephone | 208-315-4390
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2603
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City | MCCALL
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State | ID
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Zip | 83638-2603
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Country | US
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Telephone | 208-315-4390
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. JOHN ALAN HOLLEY
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Credential | M.D,
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Telephone | 208-315-4390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | M-11371
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License Number State | ID
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