Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Black Canyon Family Medicine PC

Organization Family Medicine Physician · NPI 1649300138

Black Canyon Family Medicine PC provides Family Medicine Physician services in Emmett, Idaho. Registered with an NPI since 2007.

In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

119 N Wardwell Ave
Emmett, ID 83617-3040
Phone: (208) 365-6311
Fax: (208) 365-1003
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1649300138
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tina McGuffey — Owner · (208) 365-6311
NPI enumeratedMarch 6, 2007
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 16820, Boise, ID 83715-6820

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