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Organization

ST LUKE'S REGIONAL MEDICAL CENTER

Active
Parent organization
ST LUKE'S REGIONAL MEDICAL CENTER
Other names
ST LUKE'S CLINIC - INTERMOUNTAIN ORTHOPAEDICS
Organization subpart
Yes

Provider details

NPI number
Legal business name
ST LUKE'S REGIONAL MEDICAL CENTER
Authorized official
JEFF TAYLOR (SYSTEM VP CFO)
(208) 381-2520
Entity
Organization

Contact information

Practice address
600 W ROBBINS RD, STE 401, BOISE, ID 83702-4565
(208) 383-0201
Mailing address
600 W ROBBINS RD, STE 100, BOISE, ID 83702-4565
(208) 489-4307

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
03
ID
207X00000X
Orthopaedic Surgery Physician
Primary
03
ID
207XP3100X
Pediatric Orthopaedic Surgery Physician
03
ID

Other

Enumeration date
11/05/2010
Last updated
11/05/2010
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