Organization · Type 2 NPI

ST Luke's Regional Medical Center

Pediatric Gastroenterology Physician · Boise, ID

NPI number 1801197082 Active

Practice location

100 E Idaho St, Ste 316
Boise, ID 83712-6267

Specialties and licenses

Taxonomy	Code	License
Pediatric Gastroenterology Physician Primary	2080P0206X	03 (ID)

Pediatric Gastroenterology Physician: A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.

188 other providers at this address

NPI record

NPI: 1801197082
Entity type: Organization (Type 2)
Issued: Nov 4, 2010
Last updated: Nov 4, 2010
Status: Active
Subpart: Yes of ST Luke's Regional Medical Center

Other names

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ST Luke's Clinic - Idaho Pediatric Gastroenterology · doing business as

Authorized official

Jeff Taylor
System VP CFO
(208) 381-2520

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1801197082

ST Luke's Regional Medical Center's National Provider Identifier is 1801197082, issued on Nov 4, 2010. The primary taxonomy on file is Pediatric Gastroenterology Physician (2080P0206X), and the practice location is in Boise, ID. The record was last updated on Nov 4, 2010.