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Organization
ST LUKE'S CLINIC LLC
Active
Organization
ST LUKE'S CLINIC LLC
Active
Parent organization
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Other names
St Lukes Clinic - Magic Valley/Jerome, St Lukes Jerome RHC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKES MAGIC VALLEY REGIONAL MEDICAL CENTER LTD
Authorized official
KATHRYN FOWLER (SENIOR VP, CFO)
(208) 381-8717
Entity
Organization
Contact information
Practice address
775 POLE LINE RD W, TWIN FALLS, ID 83301-5814
(208) 814-1000
Mailing address
PO BOX 640, BOISE, ID 83701-0640
(208) 706-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
207RN0300X
Nephrology Physician
—
NULL
207RN0300X
Nephrology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2083X0100X
Occupational Medicine Physician
—
NULL
2083X0100X
Occupational Medicine Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
261QR1300X
Rural Health Clinic/Center
—
NULL
Other
Enumeration date
07/08/2006
Last updated
04/23/2026
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