Organization
ST LUKE'S REGIONAL MEDICAL CENTER
Active
Parent organization
ST LUKE'S REGIONAL MEDICAL CENTER
Other names
St Luke's Cardiothoracic & Vascular Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKE'S REGIONAL MEDICAL CENTER
Authorized official
JEFF TAYLOR (SR VP/CFO)
(208) 381-2520
Entity
Organization
Contact information
Practice address
333 N 1ST ST, STE 280, BOISE, ID 83702-6100
(208) 345-6545
Mailing address
PO BOX 640, BOISE, ID 83701-0640
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
03
ID
2086S0129X
Vascular Surgery Physician
03
ID
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
03
ID
Other
Enumeration date
05/12/2010
Last updated
09/30/2016
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