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PHYSICIAN CENTER A PROFESSIONAL COMPANY MID LEVEL
NPI 1245414028
Family Medicine in Twin Falls, ID

Active since December 28, 2007
775 POLE LINE RD W, SUITE 105 & 111, TWIN FALLS, ID 83301(208) 814-8000(208) 733-9402 Get Directions Write a Review

NPPES record last updated: March 9, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Physician Center A Professional Company Mid Level NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHYSICIAN CENTER A PROFESSIONAL COMPANY MID LEVEL (NPI 1245414028) is a healthcare organization registered as a family medicine in Twin Falls, Idaho and active in the NPI registry since December 2007. The organization lists Mitchell J Moffitt, Physician, as its authorized official.

NPPES Registry Identity

NPI1245414028
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePHYSICIAN CENTER A PROFESSIONAL COMPANY MID LEVEL
Location Address775 POLE LINE RD W, SUITE 105 & 111Twin Falls, ID 83301-5814
Mailing Address775 Pole Line Rd W, Suite 105 & 111Twin Falls, ID 83301-5814 · (208) 814-8000 · Fax (208) 733-9402
Phone(208) 814-8000
Fax(208) 733-9402
Organization SubpartNo
Authorized OfficialMitchell J MoffittPhysician · (208) 814-8000
Enumeration DateDecember 28, 2007
Last NPPES UpdateMarch 9, 2013
✔ NPI 1245414028 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedPediatricsTaxonomy 208000000X
775 POLE LINE RD W, Twin Falls, ID 83301
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Other Identifiers 1

Medicaid8050368ID

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MITCHELL JACKSON MOFFITT M.D.
Pediatrics
775 POLE LINE RD W, SUITE 111
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8000
DR. RONALD WILLIAM BLAIR D.O.
Surgery
775 POLE LINE RD W, SUITE 212
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8400
JOHN A BAKER M.D.
Internal Medicine
775 POLE LINE RD W, SUITE 302
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8600
BLUE LAKES GASTROENTEROLOGY, PLLC
Internal Medicine (Gastroenterology)
775 POLE LINE RD W, SUITE 203
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8300
KOVIC SHANE BAILEY DO
Family Medicine
775 POLE LINE RD W
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8000
DANIEL G PREUCIL M.D.
Family Medicine
775 POLE LINE RD W, SUITE 105
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8000
BRUCE C MCCOMAS M.D.
Surgery
775 POLE LINE RD W, SUITE 212
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8400
HEATHER MERTEN KOHRING FNP-C
Nurse Practitioner
775 POLE LINE RD W, SUITE 203
TWIN FALLS, ID 83301
Twin Falls County (208) 814-8300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Physician Center A Professional Company Mid Level's NPI number?

The NPI number for Physician Center A Professional Company Mid Level is 1245414028. It was assigned to this organization in the NPPES registry on December 28, 2007.

Where is Physician Center A Professional Company Mid Level located?

Physician Center A Professional Company Mid Level is located at 775 Pole Line Rd W Suite 105 & 111, Twin Falls, ID 83301. The listed phone number is (208) 814-8000.

What is Physician Center A Professional Company Mid Level's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Physician Center A Professional Company Mid Level was last updated on March 9, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.