NPI 1063660645

St Lukes Regional Medical Center

Organisation Family Medicine Physician Boise, ID

Practice location

Address: 3301 N Sawgrass Way, Boise, ID 83704-4493
Phone: (208) 375-0862

Authorised official

Name: Sandy Stevenson
Title: Manager
Phone: (208) 375-0862

Registered specialties

Family Medicine Physician Primary

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

Other Family Medicine providers in Idaho →

Registry record

NPI: 1063660645
Entity type: Organization
NPI issued: 8 Sep 2008
Record last updated: 8 Sep 2008

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.