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Jacob Sup, DO
NPI 1295266401 · on the registry since 2017
Practice
- Address
- 2005 Arlington Ave
Caldwell, ID 83605 - Phone
- (208) 459-1025
- Fax
- (208) 459-1080
- Organisation at this address
- Community Health Clinics, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 13
Registry record
- Primary taxonomy
- Family Medicine Physician
207Q00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-08-07
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