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Organization
ANESTHESIA ASSOCIATES OF POCATELLO, PA
Active
Organization
ANESTHESIA ASSOCIATES OF POCATELLO, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL GILBERT CPC, CPMA (PRACTICE MANAGER)
(208) 232-7760
Entity
Organization
Contact information
Practice address
333 N 18TH AVE, SUITE A, POCATELLO, ID 83201
(208) 233-8880
(208) 232-1950
Mailing address
PO BOX 4107, POCATELLO, ID 83205-4107
(208) 232-7760
(208) 232-1950
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NULL
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002797400
—
ID
05
—
002797500
—
ID
01
—
CD5673
RAILROAD MEDICARE GROUP PTAN
ID
Enumeration date
04/10/2007
Last updated
09/24/2015
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