Organization · Type 2 NPI
Southeast Idaho Gastroenterology, PLLC
Medical Physician Assistant · Pocatello, ID
NPI number
1780867457
Active
Practice location
1151 Hospital Way Ste A
Pocatello, ID 83201-5091
Fax (208) 232-6618
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA-629 (ID) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Pocatello
About NPI 1780867457
Southeast Idaho Gastroenterology, PLLC's National Provider Identifier is 1780867457, issued on Dec 17, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Pocatello, ID. The record was last updated on Dec 17, 2007.