Organization
IDAHO PATHOLOGY LABORATORY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTOPHER A MCGEE M.D., FCAP (OWNER OF BUSINESS)
(208) 690-0364
Entity
Organization
Contact information
Practice address
777 HOSPITAL WAY, POCATELLO, ID 83201
(208) 232-7666
(208) 232-2334
Mailing address
7069 RUNNING IRON LN, POCATELLO, ID 83204-3816
(208) 690-0364
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
M11025
ID
291U00000X
Clinical Medical Laboratory
M11088
ID
Other
Enumeration date
09/20/2012
Last updated
06/12/2013
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