| NPI | 1780793596 |
|---|---|
| Doing Business As | ST LUKES MOUNTAIN STATES UROLOGY |
| Entity Type | Organization |
| Authorized Contact | JEFF TAYLOR Sr VP/CFO 208-381-2520 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208800000X Urology (Licence: ID 03) |
| Additional Taxonomies | 2088F0040X Urology, Urogynecology and Reconstructive Pelvic Surgery (Licence: ID 03) |
| 2088P0231X (Licence: ID 03) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-09-30 |