# ST JOSEPHS EAR NOSE AND THROAT CLINIC PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1952355539
- **Authorized official:** DR. THOMAS R DETAR M.D., F.A.C.S. (OWNER/MEMBER)
- **Authorized official phone:** (208) 777-1320

## Contact information

- **Practice address:** 849 N SYRINGA ST, POST FALLS, ID 83854-8794
- **Practice address phone:** (208) 777-1320
- **Practice address fax:** (208) 777-1322
- **Mailing address:** 849 N SYRINGA ST, POST FALLS, ID 83854-8794
- **Mailing address phone:** (208) 777-1320
- **Mailing address fax:** (208) 777-1322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | Yes |
| 174400000X | Specialist | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 02/06/2024