Organization
INTERMOUNTAIN EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW R. GRIGGS MD (MANAGING PARTNER)
(208) 535-4103
Entity
Organization
Contact information
Practice address
3100 CHANNING WAY, IDAHO FALLS, ID 83404-7533
(208) 535-4130
(208) 535-4125
Mailing address
PO BOX 1647, 2860 CHANNING WAY SUITE 115, IDAHO FALLS, ID 83403-1647
(208) 535-4130
(208) 535-4125
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806633300
—
ID
01
—
8H997
BLUE CROSS GROUP #
ID
Enumeration date
12/28/2005
Last updated
10/05/2021
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