Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Parent organization
ST LUKES REGIONAL MEDICAL CENTER
Other names
ST LUKES CLINIC - CAPITAL CITY FAMILY MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Authorized official
JOHN KEE (VP PHYSICIAN SERVICES)
(208) 381-5329
Entity
Organization
Contact information
Practice address
1520 W STATE ST, STE 100, BOISE, ID 83702-4085
(208) 947-7700
Mailing address
1520 W STATE ST, STE 100, BOISE, ID 83702-4085
(208) 947-7700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03
ID
207R00000X
Internal Medicine Physician
03
ID
208000000X
Pediatrics Physician
03
ID
Other
Enumeration date
07/22/2010
Last updated
07/22/2010
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