NPI 1912194085

Pocatello Podiatry Associates PA

Organisation Foot & Ankle Surgery Podiatrist Pocatello, ID

Practice location

Address: 1555 E Clark St, Pocatello, ID 83201-4133
Phone: (208) 233-4355
Fax: (208) 233-7198

Authorised official

Name: Koree Godfrey
Title: Credentialing
Phone: (208) 233-4355

Registered specialties

Foot & Ankle Surgery Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213ES0103X Licence P-82 (ID)

Other Podiatrist providers in Idaho →

Registry record

NPI: 1912194085
Entity type: Organization
NPI issued: 2 Oct 2007
Record last updated: 18 Mar 2021

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.