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Organization

ST LUKE'S REGIONAL MEDICAL CENTER

Active
Other names
SLRMC PHYSICIAN GROUP
Organization subpart
No

Provider details

NPI number
Authorized official
JANE MOTES (PFS DIRECTOR)
(208) 706-7062
Entity
Organization

Contact information

Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
03
ID
207RH0003X
Hematology & Oncology Physician
03
ID
207VM0101X
Maternal & Fetal Medicine Physician
03
ID
208000000X
Pediatrics Physician
03
ID
2080N0001X
Neonatal-Perinatal Medicine Physician
03
ID
2085B0100X
Body Imaging Physician
03
ID
2085R0202X
Diagnostic Radiology Physician
03
ID
208M00000X
Hospitalist Physician
03
ID

Other

Enumeration date
07/05/2006
Last updated
12/21/2011
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