Individual
KEITH THOMAS SIVERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 HOSPITAL DRIVE, KETCHUM, ID 83340
(208) 727-8445
(298) 727-8446
Mailing address
PO BOX 7010, KETCHUM, ID 83340-7010
(208) 725-5615
(208) 727-8446
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M5846
ID
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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