Organization
RADIOLOGY PHYSICIANS OF IDAHO
Active
Other names
POCATELLO RADIOLOGY PHYSICIANS OF IDAHO
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN A. LARSEN M.D. (PRESIDENT)
(208) 233-1187
Entity
Organization
Contact information
Practice address
1151 HOSPITAL WAY BLDG B, POCATELLO, ID 83201
(208) 233-1187
(208) 234-3841
Mailing address
P.O. BOX 2580, 1151 HOSPITAL WAY BLDG B, POCATELLO, ID 83201
(208) 233-1187
(208) 234-3841
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002473400
—
ID
Enumeration date
02/24/2006
Last updated
08/04/2014
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