# POCATELLO PODIATRY ASSOCIATES PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ambulatory Foot and Ankle Clinic, Ambulatory Foot and Ankle Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912194085
- **Authorized official:** KOREE GODFREY (CREDENTIALING)
- **Authorized official phone:** (208) 233-4355

## Contact information

- **Practice address:** 1555 E CLARK ST, POCATELLO, ID 83201-4133
- **Practice address phone:** (208) 233-4355
- **Practice address fax:** (208) 233-7198
- **Mailing address:** 1555 E CLARK ST, POCATELLO, ID 83201-4133
- **Mailing address phone:** (208) 233-4355
- **Mailing address fax:** (208) 233-7198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | P-82 | ID | Yes |

## Other

- **Enumeration date:** 10/02/2007
- **Last updated:** 03/18/2021