Organization
ORTHOPEDIC SPECIALTY INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLIN A ST MARK (PRACTICE MANAGER)
(208) 758-0486
Entity
Organization
Contact information
Practice address
1621 N 3RD ST STE 100, COEUR D ALENE, ID 83814-3384
(208) 758-0716
(208) 667-7717
Mailing address
1621 N 3RD ST STE 100, COEUR D ALENE, ID 83814-3384
(208) 758-0716
(208) 667-7717
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851799621
—
ID
Enumeration date
12/10/2014
Last updated
11/01/2023
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