# MAGIC VALLEY UROLOGY PLLC

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

## Provider details

- **NPI number:** 1790388700
- **Authorized official:** JASON GREENHALGH MD (OWNER)
- **Authorized official phone:** (208) 733-3404

## Contact information

- **Practice address:** 2095 DAWSON DR, TWIN FALLS, ID 83301-3195
- **Practice address phone:** (208) 733-3404
- **Practice address fax:** (866) 939-1381
- **Mailing address:** PO BOX 44238, BOISE, ID 83711-0238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/20/2020
- **Last updated:** 03/20/2026