Organization
SURGICAL ASSOCIATES OF SOUTHERN ID
Active
Organization
SURGICAL ASSOCIATES OF SOUTHERN ID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT SCHRADER PHYSICIAN ASSIATANT (PRESIDENT)
(208) 736-4568
Entity
Organization
Contact information
Practice address
650 ADDISON AVE W, TWIN FALLS, ID 83301-5444
(208) 737-2112
Mailing address
PO BOX 1657, TWIN FALLS, ID 83303-1657
(208) 734-3356
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA271
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010151672
BLUE SHIELD
ID
05
—
805592000
—
ID
01
—
PAWT9
BLUE CROSS
ID
Enumeration date
02/08/2007
Last updated
01/15/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up