Organization
GRAND TETON GASTROENTEROLOGY, PA
Active
Other names
DIGESTIVE HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA DAWN LEMONS CCS-P (BILLING SUPERVISOR)
(208) 528-4255
Entity
Organization
Contact information
Practice address
2770 CORTEZ AVE, IDAHO FALLS, ID 83404-7590
(208) 522-4000
(208) 528-4242
Mailing address
2770 CORTEZ AVE, IDAHO FALLS, ID 83404-7590
(208) 522-4000
(208) 528-4242
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002708500
—
ID
Enumeration date
03/15/2006
Last updated
06/07/2010
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