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Organization

STEVEN L KARASSIK MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN L KARASSIK M.D. (OWNER)
(208) 725-2171
Entity
Organization

Contact information

Practice address
191 5TH ST WEST, KETCHUM, ID 83340
(208) 725-2171
(208) 725-2015
Mailing address
PO BOX 893, KETCHUM, ID 83340-0893
(208) 725-2171
(208) 725-2015

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M5900
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002718400
ID
Enumeration date
05/14/2008
Last updated
05/14/2008
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