Search › Idaho › 207Q00000X
Matthew Fackrell, DO
NPI 1215968045 · on the registry since 2006
Practice
- Address
- 1441 Parkway Dr
Blackfoot, ID 83221 - Phone
- (208) 785-2600
- Fax
- (208) 785-8185
- Organisation at this address
- Mvh Bmc Llc
Mvh Bmc Llc
R & J Pharmacy, Inc
Blackfoot Medical Clinic Rhc
Blackfoot Medical Clinic IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 29
Additional practice sites
- 13741 E Rice Pl Ste 101, Aurora, CO
- 11417 124th Ave Ne Ste 100, Kirkland, WA
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 207Q00000X
207Q00000X
207Q00000X - Licence states on file
- WA, OR, PA, CO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-10-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho