# SANDPOINT PEDIATRICS LLP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sandpoint Pediatrics In Bonners Ferry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114954179
- **Authorized official:** MRS. BECKY SHELTON (MANAGER)
- **Authorized official phone:** (208) 265-2242

## Contact information

- **Practice address:** 420 N 2ND AVE, 100, SANDPOINT, ID 83864-1552
- **Practice address phone:** (208) 265-2242
- **Practice address fax:** (208) 265-8214
- **Mailing address:** 420 N 2ND AVE, SANDPOINT, ID 83864-1552
- **Mailing address phone:** (208) 265-2242
- **Mailing address fax:** (208) 265-8214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080A0000X | Pediatric Adolescent Medicine Physician | M-4954 | ID | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | M6447 | ID | — |

## Other

- **Enumeration date:** 06/27/2006
- **Last updated:** 08/22/2020