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

Southeastern Idaho Medical Clinics

Organization Family Medicine Physician · NPI 1982738662

Southeastern Idaho Medical Clinics provides Family Medicine Physician services in Malad City, Idaho. Licensed in Idaho. Registered with an NPI since 2007.

Licensed in
ID
In the registry since
2007
Specialties on file
2

Practice location Address checks out

230 W 200 N
Malad City, ID 83252-1109
Phone: (208) 766-2267
Fax: (208) 766-2342
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0-41 (ID)
Rural Health Clinic/Center Taxonomy 261QR1300X · Licence 0-41 (ID)

Record details

NPI number1982738662
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Johnson — Medical Director · (208) 766-2267
Other names Malad Valley Clinic
NPI enumeratedMarch 15, 2007
Last updated in NPPESSeptember 11, 2025
Mailing address2750 S 4100 W, Malad City, ID 83252-6542

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