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Organization
SOUTHERN IDAHO SURGERY CENTER PLLC
Active
Organization
SOUTHERN IDAHO SURGERY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARLON B MICHEL MD (PRESIDENT)
(208) 895-6611
Entity
Organization
Contact information
Practice address
3235 N TOWERBRIDGE WAY STE 100, MERIDIAN, ID 83646-5721
(208) 895-6611
Mailing address
3235 N TOWERBRIDGE WAY STE 100, MERIDIAN, ID 83646-5721
(208) 895-6611
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2010
Last updated
07/09/2012
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