Individual
ELENA KATHERINE PHOUTRIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1000 STATE ST, MCCALL, ID 83638-3704
(208) 634-2221
(208) 634-7112
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-15295
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/21/2013
Last updated
04/07/2025
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