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Organization
PARKWAY SURGERY CENTER LLC
Active
Organization
PARKWAY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT J LEE MD (CO MANAGER)
(208) 522-4409
Entity
Organization
Contact information
Practice address
1485 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-5100
(208) 785-5112
Mailing address
1485 PARKWAY DR, BLACKFOOT, ID 83221-1667
(208) 785-5100
(208) 785-5112
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275645574
—
ID
Enumeration date
08/31/2006
Last updated
07/12/2013
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