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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