| NPI | 1861676298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LANNIE CHECKETTS CFO 208-367-7347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RP1001X Internal Medicine Pulmonary Disease | |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 208M00000X Hospitalist | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 363A00000X Physician Assistant | |
| 363AS0400X Physician Assistant Surgical | |
| 363L00000X Nurse Practitioner | |
| 367A00000X Advanced Practice Midwife | |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2023-01-24 |