# ST LUKES REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ST LUKES CLINIC BOISE/MERIDIAN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710143672
- **Authorized official:** JOHN KEE (ADMINISTRATOR)
- **Authorized official phone:** (208) 381-5329

## Contact information

- **Practice address:** 190 E BANNOCK ST, BOISE, ID 83712-6241
- **Practice address phone:** (208) 381-2222
- **Mailing address:** PO BOX 550, BOISE, ID 83701-0550
- **Mailing address phone:** (208) 381-2222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 03 | ID | Yes |
| 207R00000X | Internal Medicine Physician | 03 | ID | — |
| 208000000X | Pediatrics Physician | 03 | ID | — |
| 208600000X | Surgery Physician | 03 | ID | — |
| 208800000X | Urology Physician | 03 | ID | — |

## Other

- **Enumeration date:** 07/31/2008
- **Last updated:** 07/31/2008