Provider Demographics
NPI:1609499094
Name:RIGBY FAMILY MEDICINE LLC
Entity Type:Organization
Organization Name:RIGBY FAMILY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JARED
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-745-3500
Mailing Address - Street 1:480 RIGBY LAKE DRIVE
Mailing Address - Street 2:
Mailing Address - City:RIGBY
Mailing Address - State:ID
Mailing Address - Zip Code:83442-0000
Mailing Address - Country:US
Mailing Address - Phone:208-745-3500
Mailing Address - Fax:208-745-3501
Practice Address - Street 1:480 RIGBY LAKE DRIVE
Practice Address - Street 2:
Practice Address - City:RIGBY
Practice Address - State:ID
Practice Address - Zip Code:83442-0000
Practice Address - Country:US
Practice Address - Phone:208-745-3500
Practice Address - Fax:208-745-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty