NPI 1063467538 · live from the CMS NPI Registry
Brent Blue, MD
Family Medicine in Driggs, ID. National Provider Identifier 1063467538, active.
NPI record
| NPI | 1063467538 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine 207Q00000X |
| Practice location | 190 Mustang Drive, Driggs, ID 83422 |
| Practice phone | 307-733-7835 |
| Mailing address | Po Box 25, Wilson, WY 83014 |
| Enumerated | May 23, 2006 |
| Last updated | March 6, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine primary | 207Q00000X | 3416A (WY) |
| Emergency Medicine | 207P00000X | A31472 (CA) |
| Clinic/Center, Urgent Care | 261QU0200X | 3416A (WY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.