Organization
LIFE SPRING WOMENS CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG ZANE HALL M.D. (PRESIDENT)
(208) 523-8844
Entity
Organization
Contact information
Practice address
1660 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4360
(208) 523-8844
(208) 529-8684
Mailing address
1660 JOHN ADAMS PKWY, IDAHO FALLS, ID 83401-4360
(208) 523-8844
(208) 529-8684
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006530
BLUE SHIELD OF IDAHO
ID
01
—
8994-6
BLUE CROSS OF IDAHO
ID
Enumeration date
02/21/2007
Last updated
03/28/2008
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