Organization
EASTERN IDAHO REGIONAL MEDICAL CENTER INPATIENT SERVICES, LLC
Active
Organization
EASTERN IDAHO REGIONAL MEDICAL CENTER INPATIENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KANE (AUTHORIZED OFFICIAL)
(801) 568-5933
Entity
Organization
Contact information
Practice address
2860 CHANNING WAY, SUITE 100, IDAHO FALLS, ID 83404-7531
(208) 535-4566
Mailing address
2860 CHANNING WAY, SUITE 100, IDAHO FALLS, ID 83404-7531
(208) 535-4566
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
12/11/2012
Last updated
12/11/2012
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