Organization
ST LUKE'S REGIONAL MEDICAL CENTER
Active
Parent organization
ST LUKE'S REGIONAL MEDICAL CENTER
Other names
St Luke's Boise Orthopedic Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKE'S REGIONAL MEDICAL CENTER
Authorized official
JOHN KEE (VP PHYSICIAN SERVICES)
(208) 381-5329
Entity
Organization
Contact information
Practice address
520 S EAGLE RD, SUITE 3213, MERIDIAN, ID 83642-6351
(208) 287-9605
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 287-9605
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
03
ID
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
03
ID
Other
Enumeration date
04/20/2010
Last updated
04/20/2010
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