Provider Demographics
NPI:1952357584
Name:POST FALLS FAMILY MEDICINE P.A.
Entity Type:Organization
Organization Name:POST FALLS FAMILY MEDICINE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-773-1577
Mailing Address - Street 1:1220 E POLSTON AVE
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-6056
Mailing Address - Country:US
Mailing Address - Phone:208-773-1577
Mailing Address - Fax:208-773-8585
Practice Address - Street 1:1220 E POLSTON AVE
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-6056
Practice Address - Country:US
Practice Address - Phone:208-773-1577
Practice Address - Fax:208-773-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID05-0214207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1952357584Medicaid
ID1375300Medicare PIN