Precision Family Medicine & Aesthetics LLC
Clinic/Center, Primary Care in Idaho Falls, ID. Organization (NPI-2).
Details
- NPI
- 1760119986
- Entity type
- Organization (NPI-2)
- Legal business name
- Precision Family Medicine & Aesthetics LLC
- Organization subpart
- No
- Enumeration date
- Aug 7, 2022
- Certification date
- Sep 17, 2026
- Last updated
- Sep 17, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
2001 S Woodruff Ave Ste 4Idaho Falls, ID 83404-6371
Phone 208-419-3271 · Fax 833-449-4588
Mailing address
2001 S Woodruff Ave Ste 4Idaho Falls, ID 83404-6371
Phone 208-419-3271 · Fax 833-449-4588
Authorized official
Bradley Radford
Fnp/Provider
2084193271
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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