| NPI | 1629397781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LANNIE CHECKETTS CFO 208-367-7347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2010-05-27 |
| Last Update Date | 2023-01-24 |