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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