Provider Demographics
NPI:1316506413
Name:SAWTOOTH FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:SAWTOOTH FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-938-5823
Mailing Address - Street 1:2320 E GALA ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-4880
Mailing Address - Country:US
Mailing Address - Phone:208-922-7982
Mailing Address - Fax:
Practice Address - Street 1:2320 E GALA ST STE 400
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-4880
Practice Address - Country:US
Practice Address - Phone:208-922-7982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service