Organization
ST LUKES MEDICAL CENTER WOODRIVER
Active
Organization
ST LUKES MEDICAL CENTER WOODRIVER
Active
Other names
ST LUKES CLINIC WOODRIVER
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF TAYLOR (CFO, VP FINANCE)
(208) 381-2520
Entity
Organization
Contact information
Practice address
100 HOSPITAL DRIVE, KETCHUM, ID 83340
(208) 788-2222
Mailing address
PO BOX 640, BOISE, ID 83701-0640
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
62
ID
207R00000X
Internal Medicine Physician
Primary
62
ID
207V00000X
Obstetrics & Gynecology Physician
62
ID
Other
Enumeration date
01/28/2008
Last updated
06/22/2016
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