NPI 1053624759

St Lukes Regional Medical Center

Organisation Family Medicine Physician Boise, ID

Practice location

Address: 1520 W State St STE 100, Boise, ID 83702-4085
Phone: (208) 947-7700

Authorised official

Name: John Kee
Title: Vp Physician Services
Phone: (208) 381-5329

Registered specialties (3)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 03 (ID)

Other Family Medicine providers in Idaho →

Internal Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207R00000X Licence 03 (ID)

Other Internal Medicine providers in Idaho →

Pediatrics Physician

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 03 (ID)

Other Pediatrics providers in Idaho →

Registry record

NPI: 1053624759
Entity type: Organization
NPI issued: 22 Jul 2010
Record last updated: 22 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.