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Organization

ST LUKES REGIONAL MEDICAL CENTER

Active
Parent organization
ST LUKES REGIONAL MEDICAL CENTER
Other names
St Lukes Elmore Medical Center Physician Group
Organization subpart
Yes

Provider details

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

Contact information

Practice address
895 N 6TH E, MOUNTAIN HOME, ID 83647-2207
(208) 587-8401
(208) 587-8406
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
03
ID
208600000X
Surgery Physician
03
ID

Other

Enumeration date
02/21/2013
Last updated
06/22/2016
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