Northern Lakes Surgery Center, LLC

NPI #1053140822 in Hayden, Idaho

Provider Information

NPI Number: 1053140822
Entity Type: Organization
Organization Name: Northern Lakes Surgery Center, LLC
Primary Specialty: Anesthesiology
Enumeration Date: Jul 30, 2024
Last Updated: Jul 30, 2024

Practice Location

Address: 8552 N GOVERNMENT WAY
City: Hayden
State: Idaho
ZIP Code: 83835-9280
Phone: (208) 457-4211

Authorized Official

Name: JEFFREY ROBERT REES LYMAN
Title: OWNER AND PHYSICIAN
Phone: (208) 758-0719

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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