# WESTERN IDAHO PATHOLOGY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275729261
- **Authorized official:** JOSEPH R EASTMAN III MD (PRESIDENT)
- **Authorized official phone:** (208) 455-3799

## Contact information

- **Practice address:** 1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
- **Practice address phone:** (208) 455-3799
- **Practice address fax:** (310) 698-7040
- **Mailing address:** PO BOX 49009, GREENWOOD, SC 29649-0001
- **Mailing address phone:** (864) 223-3070
- **Mailing address fax:** (864) 223-1396

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | NULL | Yes |
| 207ZP0102X | Anatomic Pathology & Clinical Pathology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/24/2007
- **Last updated:** 10/22/2008