| NPI | 1104972983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | B LANNIE CHECKETTS Chief Financial Officer 208-463-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207RI0011X Internal Medicine, Interventional Cardiology |
| 207QA0000X Family Medicine, Adolescent Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207QS0010X Family Medicine, Sports Medicine | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 208600000X Surgery | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2008-04-14 |