# ST LUKES REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST LUKES REGIONAL MEDICAL CENTER
- **Other names:** ST LUKES CLINIC - CAPITAL CITY FAMILY MEDICINE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053624759
- **Legal business name:** ST LUKES REGIONAL MEDICAL CENTER
- **Authorized official:** JOHN KEE (VP PHYSICIAN SERVICES)
- **Authorized official phone:** (208) 381-5329

## Contact information

- **Practice address:** 1520 W STATE ST, STE 100, BOISE, ID 83702-4085
- **Practice address phone:** (208) 947-7700
- **Mailing address:** 1520 W STATE ST, STE 100, BOISE, ID 83702-4085
- **Mailing address phone:** (208) 947-7700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 03 | ID | Yes |
| 207R00000X | Internal Medicine Physician | 03 | ID | — |
| 208000000X | Pediatrics Physician | 03 | ID | — |

## Other

- **Enumeration date:** 07/22/2010
- **Last updated:** 07/22/2010