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NPI 1578509212

NPI 1578509212 : JEREMY C MORSE MD : RATHDRUM, ID

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General NPI Number Information
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    NPI Number           |    1578509212
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    Entity Type          |    Individual 
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    Provider Name        |    JEREMY C MORSE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/21/2006
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    Last Update Date     |    03/25/2025
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Provider Practice Location Address
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    Address Line         |    15622 N HIGHWAY 41 
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    City                 |    RATHDRUM
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    State                |    ID
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    Zip                  |    83858-8710
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    Country              |    US
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    Telephone            |    208-687-4878
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    Fax                  |    208-687-4879
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Provider Business Mailing Address
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    Address Line         |    1593 E POLSTON AVE 
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    City                 |    POST FALLS
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    State                |    ID
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    Zip                  |    83854-5326
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    Country              |    US
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    Telephone            |    208-262-2300
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    Fax                  |    208-262-2349
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    M-10900
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    License Number State |    ID
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