Organization
BEAR LAKE COUNTY MEMORIAL HOSPITAL
Active
Other names
BEAR LAKE INTERNAL MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE BINGHAM (CONTRACT MANAGEMENT)
(208) 847-4327
Entity
Organization
Contact information
Practice address
166 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-1110
(208) 847-0228
Mailing address
166 S 5TH ST, MONTPELIER, ID 83254-1557
(208) 847-1110
(208) 847-0228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M7743
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806833500
—
ID
Enumeration date
04/23/2007
Last updated
12/17/2012
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