Organization
IDAHO REGIONAL HAND & UPPER EXTREMITY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DEE STUCKI DO (PRESIDENT)
(208) 235-4263
Entity
Organization
Contact information
Practice address
444 HOSPITAL WAY STE 710, POCATELLO, ID 83201
(208) 235-4263
(208) 233-4268
Mailing address
444 HOSPITAL WAY STE 710, POCATELLO, ID 83201-2745
(208) 235-4263
(208) 233-4268
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
M-8547
ID
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
O-0574
ID
363AS0400X
Surgical Physician Assistant
PA-684
ID
Other
Enumeration date
03/05/2013
Last updated
08/30/2018
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