Idaho Falls Surcigal Center
NPI #1053481218 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1053481218
- Entity Type
- Organization
- Organization Name
- Idaho Falls Surcigal Center
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Nov 8, 2006
- Last Updated
- Jun 9, 2008
Practice Location
- Address
- 1945 E 17TH ST
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-6429
- Phone
- (208) 529-1945
Authorized Official
- Name
- MARK L PETERSEN, MD
- Title
- PRESIDENT
- Phone
- (208) 529-1945
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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