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Organization
STERLING PROVIDER GROUP
Active
Organization
STERLING PROVIDER GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORBIN BUNNAGE PA-C (PROVIDER/OWNER)
(208) 542-9111
Entity
Organization
Contact information
Practice address
939 S HIGHWAY 89 STE 1, LOGAN, UT 84321-6581
(435) 787-8504
(435) 787-8509
Mailing address
740 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5285
(208) 542-9111
(208) 542-9114
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QP2300X
Primary Care Clinic/Center
—
NULL
261QU0200X
Urgent Care Clinic/Center
Primary
—
NULL
261QX0100X
Occupational Medicine Clinic/Center
—
NULL
Other
Enumeration date
11/04/2019
Last updated
06/17/2026
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