Organization
ST LUKES REGIONAL MEDICAL CENTER
Active
Parent organization
ST LUKES REGIONAL MEDICAL CENTER
Other names
ST LUKES CLINIC - CALDWELL UROLOGY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST LUKES REGIONAL MEDICAL CENTER
Authorized official
JEFF TAYLOR (SYSTEM VP CFO)
(208) 381-2520
Entity
Organization
Contact information
Practice address
1620 S KIMBALL AVE, CALDWELL, ID 83605-4547
(208) 454-9181
Mailing address
1620 S KIMBALL AVE, CALDWELL, ID 83605-4547
(208) 454-9181
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
03
ID
Other
Enumeration date
12/21/2010
Last updated
12/21/2010
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