Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Other names
ST LUKES CLINIC BOISE/MERIDIAN
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN KEE (ADMINISTRATOR)
(208) 381-5329
Entity
Organization
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
PO BOX 550, BOISE, ID 83701-0550
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
03
ID
207R00000X
Internal Medicine Physician
03
ID
208000000X
Pediatrics Physician
03
ID
208600000X
Surgery Physician
03
ID
208800000X
Urology Physician
03
ID
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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