# STEVEN L KARASSIK MD PA

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

## Provider details

- **NPI number:** 1386811826
- **Authorized official:** STEVEN L KARASSIK M.D. (OWNER)
- **Authorized official phone:** (208) 725-2171

## Contact information

- **Practice address:** 191 5TH ST WEST, KETCHUM, ID 83340
- **Practice address phone:** (208) 725-2171
- **Practice address fax:** (208) 725-2015
- **Mailing address:** PO BOX 893, KETCHUM, ID 83340-0893
- **Mailing address phone:** (208) 725-2171
- **Mailing address fax:** (208) 725-2015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M5900 | ID | Yes |

## Other

- **Enumeration date:** 05/14/2008
- **Last updated:** 05/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 002718400 | — | ID |