| NPI | 1992759930 |
|---|---|
| Doing Business As | IDAHO SURGICENTER SOUTH |
| Entity Type | Organization |
| Authorized Contact | SEAN BARNARD Administrator 208-852-6242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P166) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P92) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P153) | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2022-01-31 |