MEDICARE: SUZANNE F MCCONNAUGHEY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	O-0545	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538142609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE F MCCONNAUGHEY DO

Provider Business Mailing Address
First Line	:	1512 12TH AVE RD
Second Line	:	APOGEE PHYSICIANS
City	:	NAMPA
State	:	ID
Zip	:	83686-6008
Country	:	US
Telephone Number	:	208-463-5164
Fax Number	:	208-463-5172

Provider Business Practice Location Address
First Line	:	1512 12TH AVE RD
Second Line	:	APOGEE PHYSICIANS
City	:	NAMPA
State	:	ID
Zip	:	83686-6008
Country	:	US
Telephone Number	:	208-463-5164
Fax Number	:	208-463-5172

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	09/15/2009

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