Active NPI 1699764209 Individual Practitioner Female Practitioner

Dr. Kay Bishop , MD

Specialist • Rigby, ID

Professional Overview & Biography Verified Profile Summary

Dr. Kay Bishop, MD is a registered healthcare professional specializing in Specialist in Rigby, ID. Practice services are available at 703 RIGBY LAKE DR under active NPI credentials.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

703 Rigby Lake Dr

Rigby, ID 834425192

Telephone 2087450200

Fax 2087450212

Associated Practice Facility / Clinic

🏢 Dermatology Of Eastern Idaho Pa Facility NPI 1548259161

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Rigby, ID

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 35.5 Yrs

Regional Practice Density

1 Specialists

Practicing in Rigby, ID (194 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

16.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,303	222	$6.37	$6.07
99213 Established patient office or other outpatient visit, typically 15 minutes	517	359	$85.45	$84.24
17000 Destruction of skin growth	378	289	$64.09	$53.88
11104 Punch biopsy, first skin growth	144	123	$118.44	$110.27
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	141	128	$53.90	$52.16
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	96	77	$633.35	$513.80
17004 Destruction of precancer skin growth, 15 or more growths	58	43	$154.09	$152.94
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	47	32	$387.34	$375.51
11105 Punch biopsy, each additional skin growth	39	28	$57.22	$54.15
17110 Destruction of up to 14 skin growths	36	35	$104.75	$95.17
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	30	30	$289.79	$153.41
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	27	25	$278.21	$183.77
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	19	$120.18	$119.22
69100 Biopsy of ear	19	13	$91.06	$64.12
11102 Tangential biopsy of single skin lesion	18	18	$91.76	$88.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,395	238	$8.75	$6.20
99213 Established patient office or other outpatient visit, typically 15 minutes	489	355	$96.90	$84.44
17000 Destruction of skin growth	405	300	$83.26	$53.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	187	167	$62.20	$52.55
11104 Punch biopsy, first skin growth	156	137	$137.14	$111.65
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	106	81	$792.93	$525.01
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	76	12	$1.68	$1.06
17004 Destruction of precancer skin growth, 15 or more growths	56	42	$188.98	$156.09
11105 Punch biopsy, each additional skin growth	47	26	$63.67	$54.70
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	44	34	$506.14	$380.89
17110 Destruction of up to 14 skin growths	41	38	$125.76	$97.18
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	38	35	$324.63	$203.80
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	29	28	$337.50	$161.76
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	20	$132.19	$119.76
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	18	$245.21	$129.72
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$342.44	$179.85
11102 Tangential biopsy of single skin lesion	14	14	$101.36	$87.10
69100 Biopsy of ear	12	12	$110.62	$81.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	3,200	15	$2.00	$1.58
17003 Destruction of precancer skin growth, 2-14 growths	1,472	255	$15.00	$6.24
99213 Established patient office or other outpatient visit, typically 15 minutes	564	437	$125.00	$84.52
17000 Destruction of skin growth	441	340	$139.00	$52.80
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	218	179	$85.00	$52.39
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	204	14	$160.00	$97.05
11104 Punch biopsy, first skin growth	184	154	$182.00	$110.96
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	133	105	$1108.00	$508.41
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	69	47	$670.00	$373.55
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	61	12	$2.75	$1.17
17004 Destruction of precancer skin growth, 15 or more growths	56	43	$289.00	$155.95
11105 Punch biopsy, each additional skin growth	49	35	$95.00	$55.12
17110 Destruction of up to 14 skin growths	45	44	$190.00	$100.69
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	37	35	$510.00	$159.26
90662 Influenza vaccine split virus, preservative free	36	36	$72.50	$67.30
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	33	29	$185.00	$120.34
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	26	25	$518.00	$210.96
69100 Biopsy of ear	20	19	$175.00	$54.60
G0008 Administration of influenza virus vaccine	19	19	$45.00	$27.40
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	17	17	$595.00	$179.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$184.00	$98.50
11102 Tangential biopsy of single skin lesion	11	11	$146.00	$90.43

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	3,400	13	$2.00	$1.36
17003 Destruction of precancer skin growth, 2-14 growths	1,446	266	$15.00	$6.04
99213 Established patient office or other outpatient visit, typically 15 minutes	517	393	$125.00	$85.45
17000 Destruction of skin growth	470	356	$139.00	$51.53
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	254	210	$85.00	$52.42
11104 Punch biopsy, first skin growth	234	188	$182.00	$115.55
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	176	138	$1108.00	$490.02
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	104	71	$670.00	$380.70
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	89	21	$2.75	$1.27
11105 Punch biopsy, each additional skin growth	61	47	$95.00	$56.54
17110 Destruction of up to 14 skin growths	55	50	$190.00	$96.38
17004 Destruction of precancer skin growth, 15 or more growths	53	42	$289.00	$153.80
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	39	39	$510.00	$155.26
90662 Influenza vaccine split virus, preservative free	34	34	$66.32	$64.31
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	32	32	$518.00	$205.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	19	$185.00	$122.08
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	22	22	$1330.00	$716.83
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	21	21	$595.00	$180.02
69100 Biopsy of ear	17	13	$175.00	$60.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	17	17	$184.00	$105.27
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	16	16	$495.00	$181.60
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	15	11	$423.00	$129.02
11102 Tangential biopsy of single skin lesion	14	14	$146.00	$85.93
11103 Biopsy of related skin growth, each additional growth	14	11	$84.00	$48.98
11900 Injection into skin growth, 1-7 growths	13	12	$95.00	$36.39
99202 New patient office or other outpatient visit, typically 20 minutes	13	13	$129.00	$67.85
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	13	13	$1730.00	$890.60
12034 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 7.6-12.5 cm	13	11	$540.00	$240.77
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	11	11	$1735.00	$915.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	3,200	14	$2.00	$1.48
17003 Destruction of precancer skin growth, 2-14 growths	1,651	264	$15.00	$5.67
17000 Destruction of skin growth	437	351	$139.00	$52.57
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	331	311	$185.00	$103.19
99213 Established patient office or other outpatient visit, typically 15 minutes	272	211	$125.00	$71.01
11104 Punch biopsy, first skin growth	230	201	$182.79	$111.20
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	176	12	$160.00	$106.10
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	166	132	$1108.00	$503.37
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	158	117	$80.16	$40.45
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	93	14	$2.75	$1.45
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	93	58	$670.00	$372.03
17004 Destruction of precancer skin growth, 15 or more growths	73	56	$289.00	$148.68
11105 Punch biopsy, each additional skin growth	65	46	$95.00	$55.50
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	56	56	$518.00	$187.41
29580 Strapping, unna boot	43	12	$123.72	$64.16
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	41	41	$510.00	$148.60
90662 Influenza vaccine split virus, preservative free	34	34	$60.00	$59.40
G0008 Administration of influenza virus vaccine	25	25	$45.00	$15.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$184.00	$101.57
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	18	18	$595.00	$186.67
69100 Biopsy of ear	18	15	$175.00	$69.12
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	17	17	$1330.00	$731.80
17110 Destruction of up to 14 skin growths	14	14	$190.00	$100.58
96574 Application of light with debridement to destroy precancer skin growth	12	12	$425.00	$247.46
12042 Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm	11	11	$495.00	$192.65
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	11	11	$481.00	$132.22

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	7,301	34	$2.04	$1.38
17003 Destruction of precancer skin growth, 2-14 growths	1,756	285	$15.00	$5.19
17000 Destruction of skin growth	461	355	$139.00	$52.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	349	329	$185.00	$102.82
11104 Punch biopsy, first skin growth	235	193	$182.00	$108.58
99213 Established patient office or other outpatient visit, typically 15 minutes	210	179	$125.00	$70.30
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	182	148	$1108.00	$492.62
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	181	11	$160.00	$104.91
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	151	127	$85.00	$42.38
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	103	66	$670.00	$370.34
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	91	20	$2.75	$1.58
17004 Destruction of precancer skin growth, 15 or more growths	63	48	$289.00	$142.10
11105 Punch biopsy, each additional skin growth	50	41	$95.00	$56.91
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	36	35	$510.00	$152.65
90662 Influenza vaccine split virus, preservative free	32	31	$59.75	$54.57
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	29	29	$518.00	$205.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$184.00	$102.08
96574 Application of light with debridement to destroy precancer skin growth	23	20	$425.00	$238.24
G0008 Administration of influenza virus vaccine	21	20	$45.00	$15.43
13152 Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm	18	18	$873.00	$252.13
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	17	17	$1730.00	$866.43
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	16	16	$595.00	$174.91
69100 Biopsy of ear	16	16	$175.00	$74.66
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	15	15	$1735.00	$910.21
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	14	13	$1330.00	$705.47
17110 Destruction of up to 14 skin growths	14	13	$190.00	$88.15
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	12	12	$481.00	$132.96
11102 Tangential biopsy of single skin lesion	12	12	$146.00	$84.32

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	13,000	53	$1.83	$1.42
17003 Destruction of precancer skin growth, 2-14 growths	1,263	207	$15.00	$4.80
17000 Destruction of skin growth	343	268	$139.00	$52.55
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	264	249	$185.00	$101.06
96910 Skin application of tar and ultraviolet B or petrolatum and ultraviolet B	222	18	$127.75	$101.16
99213 Established patient office or other outpatient visit, typically 15 minutes	209	158	$125.29	$68.41
11100 Biopsy of single growth of skin and/or tissue	177	150	$177.00	$89.85
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	159	128	$1108.00	$470.15
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	115	93	$86.39	$40.81
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	106	75	$670.00	$358.25
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	81	16	$2.75	$1.77
11101 Biopsy of each additional growth of skin and/or tissue	60	37	$60.00	$30.31
17004 Destruction of precancer skin growth, 15 or more growths	56	44	$289.00	$133.53
29580 Strapping, unna boot	53	11	$156.23	$74.85
96574 Application of light with debridement to destroy precancer skin growth	31	28	$425.00	$224.06
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	29	29	$518.00	$230.73
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	26	26	$510.00	$146.53
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	22	21	$1330.00	$671.75
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	20	19	$595.00	$159.56
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	16	15	$830.00	$233.78
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	14	14	$1735.00	$939.84
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	12	$423.00	$123.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$184.00	$100.58
90662 Influenza vaccine split virus, preservative free	11	11	$58.00	$52.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,400	228	$11.98	$5.09
17000 Destruction of skin growth	391	296	$111.19	$53.04
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	258	243	$153.02	$100.24
99213 Established patient office or other outpatient visit, typically 15 minutes	238	180	$102.46	$67.03
11100 Biopsy of single growth of skin and/or tissue	181	157	$147.57	$88.83
17311 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks	178	143	$937.33	$446.24
17312 Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks	110	75	$566.74	$355.66
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	109	79	$70.96	$40.30
11101 Biopsy of each additional growth of skin and/or tissue	83	47	$51.57	$30.18
17004 Destruction of precancer skin growth, 15 or more growths	65	54	$216.63	$136.73
12052 Repair of wound (2.6 to 5.0 centimeters) of face, ears, eyelids, nose, lips, and/or mouth	46	43	$433.70	$152.39
G0008 Administration of influenza virus vaccine	33	33	$41.27	$23.26
14061 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.1-30.0 sq cm	20	18	$1419.20	$936.42
90662 Influenza vaccine split virus, preservative free	18	18	$55.00	$48.05
12053 Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 5.1-7.5 cm	18	18	$489.22	$175.67
14060 Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less	17	17	$1012.88	$696.01
15260 Relocation of patient skin to nose, ears, eyelids, and/or lips (20 sq centimeters or less)	16	16	$1441.38	$906.23
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	16	15	$734.00	$259.55
69100 Biopsy of ear	16	16	$140.00	$72.16
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	16	16	$400.50	$208.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$146.62	$100.14
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	13	13	$577.46	$210.75
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	12	11	$175.00	$121.45

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License ID M-6569

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

002745900 (ID)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Quinn Ranson , PA-C

Physician Assistant

NPI 1508296476

Physician Assistant (Certified)

Cameron French , PA-C

Physician Assistant - Medical

NPI 1841289469

Physician Assistant (Certified)

Ryan Black , PA-C

Physician Assistant

NPI 1932452091

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active June 30, 2010

NPI status registered as active in NPPES database

📍

Updated Practice Location June 30, 2010

Registered at 703 RIGBY LAKE DR, RIGBY, ID 834425192 (Tel: 2087450200)

📍

Updated Business Mailing Address June 30, 2010

Registered at 703 RIGBY LAKE DR, RIGBY, ID 834425192 (Tel: 2087450200)

👤

Provider Name / Credentials Updated June 30, 2010

Recorded as KAY BISHOP, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 30, 2010

Specialist (License #M-6569 in ID)

🟢

Initial NPI Registration & Enumeration October 17, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1699764209

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 17, 2005

Last Update: June 30, 2010

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

703 Rigby Lake Dr

Rigby, ID 834425192

Phone: 2087450200

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.