Individual provider · Type 1 NPI

Leslie Jean McGovern, PA-C, MHE, ATC, LAT

Medical Physician Assistant · Pocatello, ID

NPI number 1831184712 Active

Practice location

777 Hospital Way
Pocatello, ID 83201-5175

Call (480) 421-9700 Map

Fax (480) 421-9899

Mailing address

PO Box 15070
Scottsdale, AZ 85267-5070

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Surgical Physician Assistant 363AS0400XPA868 (ID)
Medical Physician Assistant Primary 363AM0700XPA868 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1831184712

Leslie Jean McGovern, PA-C, MHE, ATC, LAT's National Provider Identifier is 1831184712, issued on Sep 15, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Pocatello, ID. The record was last updated on Jul 19, 2011.