Organization
ANESTHESIA ASSOCIATES OF POCATELLO, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL GILBERT CPC, CPMA (PRACTICE MANAGER)
(208) 232-7760
Entity
Organization
Contact information
Practice address
333 N 18TH AVE, SUITE A, POCATELLO, ID 83201
(208) 233-8880
(208) 232-1950
Mailing address
PO BOX 4107, POCATELLO, ID 83205-4107
(208) 232-7760
(208) 232-1950
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002797400
—
ID
05
—
002797500
—
ID
01
—
CD5673
RAILROAD MEDICARE GROUP PTAN
ID
Enumeration date
04/10/2007
Last updated
09/24/2015
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